CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Anti-CCR9 chimeric antigen receptor T cells for T-cell acute lymphoblastic leukemia.
Anti-CCR9 chimeric antigen receptor T cells for T-cell acute lymphoblastic leukemia.
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T细胞急性淋巴细胞白血病(T-ALL)是一种未成熟T淋巴细胞的侵袭性恶性肿瘤,与B细胞急性淋巴细胞白血病相比,其诱导失败率更高。在B细胞急性淋巴细胞白血病中应用的强效免疫治疗方法已经彻底改变了治疗模式,但在T-ALL中却面临更大挑战,主要原因是缺乏仅在恶性T细胞而不在健康T细胞上表达的靶抗原。与B细胞清除不同,T细胞发育不全具有高度毒性。在此,我们显示趋化因子受体CCR9在超过70%的T-ALL病例中表达,包括超过85%的复发/难治性疾病,并且仅在一小部分(<5%)正常T细胞上表达。利用细胞系模型和患者来源的异种移植,我们发现靶向CCR9的嵌合抗原受体(CAR)T细胞对自相残杀具有抗性,并且在体外和体内均具有强效抗白血病活性,即使在低靶抗原密度下也是如此。我们提出,抗CCR9 CAR-T 细胞可能是T-ALL的一种高效治疗策略,可避免T细胞发育不全以及其他方法中复杂的基因组工程需求。
T cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of immature T lymphocytes, associated with higher rates of induction failure compared with those in B cell acute lymphoblastic leukemia. The potent immunotherapeutic approaches applied in B cell acute lymphoblastic leukemia, which have revolutionized the treatment paradigm, have proven more challenging in T-ALL, largely due to a lack of target antigens expressed on malignant but not healthy T cells. Unlike B cell depletion, T-cell aplasia is highly toxic.
Here, we show that the chemokine receptor CCR9 is expressed in >70% of cases of T-ALL, including >85% of relapsed/refractory disease, and only on a small fraction (<5%) of normal T cells. Using cell line models and patient-derived xenografts, we found that chimeric antigen receptor (CAR) T-cells targeting CCR9 are resistant to fratricide and have potent antileukemic activity both in vitro and in vivo, even at low target antigen density.
We propose that anti-CCR9 CAR-T cells could be a highly effective treatment strategy for T-ALL, avoiding T cell aplasia and the need for genome engineering that complicate other approaches.
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