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:Decade-long leukaemia remissions with persistence of CD4(+) CAR T cells.
将T淋巴细胞重编程为靶向肿瘤细胞后进行过继转移,已显示出治疗多种癌症的潜力1-7。
过继转移经重编程靶向肿瘤细胞的T淋巴细胞已显示出治疗多种癌症的潜力1-7。然而,关于输注细胞的长期潜力和克隆稳定性知之甚少。在此,我们研究了2010年实现完全缓解的两名慢性淋巴细胞白血病患者中持久存在的CD19重定向嵌合抗原受体(CAR)T细胞1-4。CAR T细胞在输注后十多年仍可检测到,两名患者均维持缓解。值得注意的是,两名患者中均出现了一个高度活化的CD4+群体,在较晚的时间点主导了CAR T细胞群体。这种转变反映在CAR T细胞克隆构成的稳定化上,其 repertoire 由少数克隆主导。单细胞分析表明,这些长期存续的CD4+ CAR T细胞表现出细胞毒性特征,同时具有持续的功能活化和增殖。此外,纵向分析揭示了一个gamma delta CAR T细胞群体,在一名患者的初始应答阶段与CD8+ CAR T细胞同时显著扩增。我们对这些意外发现的CAR T细胞群体的识别和表征,为与白血病抗癌应答和长期缓解相关的CAR T细胞特征提供了新的见解。
The adoptive transfer of T lymphocytes reprogrammed to target tumour cells has demonstrated potential for treatment of various cancers 1-7 . However, little is known about the long-term potential and clonal stability of the infused cells. Here we studied long-lasting CD19-redirected chimeric antigen receptor (CAR) T cells in two patients with chronic lymphocytic leukaemia 1-4 who achieved a complete remission in 2010. CAR T cells remained detectable more than ten years after infusion, with sustained remission in both patients. Notably, a highly activated CD4 + population emerged in both patients, dominating the CAR T cell population at the later time points. This transition was reflected in the stabilization of the clonal make-up of CAR T cells with a repertoire dominated by a small number of clones. Single-cell profiling demonstrated that these long-persisting CD4 + CAR T cells exhibited cytotoxic characteristics along with ongoing functional activation and proliferation. In addition, longitudinal profiling revealed a population of gamma delta CAR T cells that prominently expanded in one patient concomitant with CD8 + CAR T cells during the initial response phase. Our identification and characterization of these unexpected CAR T cell populations provide novel insight into the CAR T cell characteristics associated with anti-cancer response and long-term remission in leukaemia.
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