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:Gp350-anchored extracellular vesicles: promising vehicles for delivering therapeutic drugs of B cell malignancies.
我们的发现提示,载药 RBC-EVs/gp350 Etp 或可用于 CD21+ B 细胞恶性肿瘤的治疗。
嵌合抗原受体修饰T(CAR-T)细胞疗法已成功用于治疗B细胞急性淋巴细胞白血病,但对伯基特淋巴瘤(BL)和慢性B细胞淋巴细胞白血病(B-CLL)效果不理想;致命副作用也严重限制CAR-T应用。细胞外囊泡(EV)是良好的治疗药物载体,但未经修饰的EV给药后主要蓄积于肝脏。Epstein-Barr病毒包膜糖蛋白gp350可有效结合B细胞上的CD21。本研究利用gp350跨膜区并结合低电压电穿孔,将gp350直接锚定至红细胞来源EV(RBC-EV)表面。结果显示,gp350可高效锚定于RBC-EV,所得gp350锚定RBC-EV(RBC-EV/gp350 Etp)与未修饰RBC-EV相比,对CD21阳性BL和B-CLL靶向性增强。装载阿霉素或氟达拉滨后,RBC-EV/gp350 Etp分别对CD21阳性BL或B-CLL具有强效细胞毒性和治疗作用。此外,载药RBC-EV/gp350 Etp未表现出明显全身毒性,可特异性诱导肿瘤B细胞凋亡而不影响正常B细胞。因此,研究结果提示,载药RBC-EV/gp350 Etp可用于治疗CD21阳性B细胞恶性肿瘤。
Although chimeric antigen receptor-modified (CAR) T cell therapy has been successfully applied in the treatment of acute B lymphocytic leukemia, its effect on Burkitt lymphoma (BL) and chronic B lymphocytic leukemia (B-CLL) is unsatisfactory. Moreover, fatal side effects greatly impede CAR T cell application. Extracellular vesicles (EVs) are excellent carriers of therapeutic agents. Nevertheless, EVs mainly accumulate in the liver when administered without modification. As an envelope glycoprotein of Epstein-Barr viruses, gp350 can efficiently bind CD21 on B cells. Here, gp350 was directly anchored onto red blood cell EVs (RBC-EVs) via its transmembrane region combined with low-voltage electroporation. The results showed that gp350 could anchor to RBC-EVs with high efficiency and that the resulting gp350-anchored RBC-EVs (RBC-EVs/gp350 Etp ) exhibited increased targeting to CD21 + BL and B-CLL relative to RBC-EVs. After the loading of doxorubicin or fludarabine, RBC-EVs/gp350 Etp had powerful cytotoxicity and therapeutic efficacy on CD21 + BL or B-CLL, respectively. Moreover, RBC-EVs/gp350 Etp loaded with a drug did not exhibit any apparent systemic toxicity and specifically induced the apoptosis of tumor B cells but not normal B cells. Therefore, our findings indicate that drug-loaded RBC-EVs/gp350 Etp may be adopted in the treatment of CD21 + B cell malignancies.
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