决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Exploiting Natural Killer Cell Engagers to Control Pediatric B-cell Precursor Acute Lymphoblastic Leukemia.
这些数据支持在移植前或移植后使用 NKp46/CD16A/CD19-NKCE 对抗难治/复发性白血病。
自然杀伤(NK)细胞是一种有前景的抗肿瘤免疫治疗细胞类型,兼具疗效和安全性,尤其适用于血液系统恶性肿瘤。研究表明,在半相合造血干细胞移植(haplo-HSCT)背景下,NK细胞可发挥抗白血病活性。已有产品被开发出来,使NK细胞仅在肿瘤细胞交联时才被激活,从而避免脱靶效应。本研究在体外测试不同NK细胞连接器(NKCE)的作用:这些分子可分别触发NKp46或NKp30并同时结合CD16A,靶向CD19或CD20,以诱导儿童B细胞前体急性淋巴细胞白血病(BCP-ALL)细胞杀伤。靶细胞包括NALM-16和MHH-CALL-4细胞系及4例原代白血病细胞;效应细胞为健康供者的静息NK细胞,以及儿童白血病患者接受去除T/B细胞的haplo-HSCT后来源的NK细胞。所有NKCE均能有效杀伤对NK细胞耐受的MHH-CALL-4细胞。脱颗粒和IFN产生也显示NK细胞对MHH-CALL-4的活性增强。由于原代BCP-ALL缺乏CD20且CD19高表达,我们重点研究靶向CD19的NKCE。即使面对原代BCP-ALL原始细胞,基于NKp46和NKp30的NKCE诱导NK细胞活性的能力也相近。患者移植后来源的NK细胞同样显示疗效。NKCE诱导的BCP-ALL应答可克服HLA特异性抑制相互作用,但最强应答见于异体反应性NK细胞亚群。这些数据支持使用NKp46/CD16A/CD19-NKCE,在移植前或移植后环境中治疗难治/复发白血病。
Natural killer (NK) cells represent a promising cell type in antitumor immunotherapy for efficacy and safety, particularly in the treatment of hematologic malignancies. NK cells have been shown to exert antileukemia activity in the context of haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Products have been developed to boost the activation of NK cells only when cross-linked by tumor cells, avoiding any off-target effect. Here, we tested the in vitro effect of different NK-cell engagers (NKCE), which trigger either NKp46 or NKp30 together with CD16A, and target either CD19 or CD20 to induce killing of pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Target cells were NALM-16 and MHH-CALL-4 cell lines and four primary leukemias, while effector cells were resting NK cells derived from healthy donors and pediatric patients with leukemia after T/B-depleted haplo-HSCT. The NK cell-resistant MHH-CALL-4 was efficiently killed using all NKCEs. Boosting of NK activity against MHH-CALL-4 was also evident by degranulation and IFN production. Because of the lack of CD20 and high expression of CD19 on primary BCP-ALL, we focused on NKCEs targeting CD19. NKp46- and NKp30-based NKCEs displayed similar potency at inducing NK-cell activity, even when challenged with primary BCP-ALL blasts. Their efficacy was shown also using NK cells derived from transplanted patients. NKCE-induced activation against BCP-ALL can override HLA-specific inhibitory interactions, although the strongest response was observed by the alloreactive NK-cell subset. These data support the therapeutic use of NKp46/CD16A/CD19-NKCE to fight refractory/relapsed leukemia in pretransplantation or posttransplantation settings.
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