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:Allogeneic double-negative CAR-T cells inhibit tumor growth without off-tumor toxicities.
自体CAR-T(CAR-T)细胞疗法的发展彻底改变了癌症治疗。
自体CAR-T(CAR-T)细胞疗法的发展已经彻底改变了癌症治疗。然而,CAR-T细胞疗法的实施面临诸多挑战,包括高昂的成本、漫长的生产时间和生产失败。为克服这些问题,研究者尝试利用供者来源的常规CD4+或CD8+T细胞(T convs)开发同种异体CAR-T细胞,但严重的移植物抗宿主病(GvHD)和宿主免疫排斥使这一策略面临困难。CD3+CD4-CD8-双阴性T细胞(DNTs)是一种罕见的成熟T细胞亚群,已被证明满足即用型细胞疗法的要求,包括可规模化扩增、可冷冻保存、不依赖供者的抗癌功能、抗排斥性,以及未观察到包括GvHD在内的脱靶毒性。为克服CAR-T convs所面临的挑战,我们评估了使用健康供者来源的同种异体DNTs作为CAR-T细胞治疗平台的可行性、安全性和有效性。我们成功地将第二代抗CD19-CAR(CAR19)转导至DNTs中,且未损害其内源性特征或即用型特性。CAR19-DNTs诱导了对B细胞急性淋巴细胞白血病(B-ALL)的抗原特异性细胞毒性。此外,CAR19-DNTs在异种移植模型中显示出对经基因修饰表达CD19的肺癌的有效浸润和肿瘤控制。CAR19-DNT的疗效与CAR19-T convs相当。然而,与CAR19-T convs不同,CAR19-DNTs在异种移植模型中未引起同种异体反应性或异种GvHD相关死亡。这些研究表明,利用同种异体DNTs作为CAR技术平台具有潜力,可提供一种安全、有效且患者可及的CAR-T细胞治疗选择。
The development of autologous chimeric antigen receptor T (CAR-T) cell therapies has revolutionized cancer treatment. Nevertheless, the delivery of CAR-T cell therapy faces challenges, including high costs, lengthy production times, and manufacturing failures. To overcome this, attempts have been made to develop allogeneic CAR-T cells using donor-derived conventional CD4 + or CD8 + T cells (T convs ), but severe graft-versus-host disease (GvHD) and host immune rejection have made this challenging. CD3 + CD4 - CD8 - double-negative T cells (DNTs) are a rare subset of mature T cells shown to fulfill the requirements of an off-the-shelf cellular therapy, including scalability, cryopreservability, donor-independent anticancer function, resistance to rejection, and no observed off-tumor toxicity including GvHD. To overcome the challenges faced with CAR-T convs , we evaluated the feasibility, safety, and efficacy of using healthy donor-derived allogeneic DNTs as a CAR-T cell therapy platform. We successfully transduced DNTs with a second-generation anti-CD19-CAR (CAR19) without hampering their endogenous characteristics or off-the-shelf properties. CAR19-DNTs induced antigen-specific cytotoxicity against B cell acute lymphoblastic leukemia (B-ALL). In addition, CAR19-DNTs showed effective infiltration and tumor control against lung cancer genetically modified to express CD19 in xenograft models. CAR19-DNT efficacy was comparable with that of CAR19-T convs . However, unlike CAR19-T convs , CAR19-DNTs did not cause alloreactivity or xenogeneic GvHD-related mortality in xenograft models. These studies demonstrate the potential of using allogeneic DNTs as a platform for CAR technology to provide a safe, effective, and patient-accessible CAR-T cell treatment option.
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