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:Engineering naturally occurring CD7- T cells for the immunotherapy of hematological malignancies.
靶向T细胞急性淋巴细胞白血病(T-ALL)的嵌合抗原受体(CAR)T细胞疗法面临抗原选择和T细胞持久性有限等局限性。
靶向T细胞急性淋巴细胞白血病(T-ALL)的嵌合抗原受体(CAR)T细胞疗法面临抗原选择和T细胞持久性有限等局限性。CD7是靶向T-ALL的一个有吸引力的抗原,但其在健康T细胞上的重叠表达导致CD7-CAR T细胞发生自相残杀,需要额外的基因修饰。我们利用天然存在的CD7- T细胞来生成CD7-CAR(CD7-CARCD7-)T细胞。CD7-CARCD7- T细胞主要表现出CD4+记忆表型,并在体外和异种移植小鼠模型中长期暴露于抗原后具有显著的抗肿瘤活性。基于这些令人鼓舞的结果,我们接下来探索了CD7- T细胞在CD19+血液系统恶性肿瘤免疫治疗中的效用。直接比较未选择的(bulk)CD19-CAR和CD19-CARCD7- T细胞显示,CD19-CARCD7- T细胞在体外和体内均比其bulk对应细胞具有增强的抗肿瘤活性。最后,为了深入了解CD7基因低表达(CD7lo)的CD19-CAR T细胞在人体中的行为,我们挖掘了来自我们机构CD19-CAR T细胞临床研究的单细胞基因和T细胞受体(TCR)表达数据集。CD19-CARCD7lo T细胞存在于初始CD19-CAR T细胞产品中,并可在输注后检测到。有趣的是,输注后观察到的唯一功能性CD4+ CD19-CAR T细胞簇表现出CD7lo表达。此外,对治疗有反应的患者样本中CD7lo T细胞的比例高于无反应者(NCT03573700)。因此,CARCD7- T细胞具有良好的生物学特性,可能为T-ALL和其他血液系统恶性肿瘤的过继细胞治疗提供一个有前景的T细胞亚群。
Chimeric antigen receptor (CAR) T-cell therapy targeting T-cell acute lymphoblastic leukemia (T-ALL) faces limitations such as antigen selection and limited T-cell persistence. CD7 is an attractive antigen for targeting T-ALL, but overlapping expression on healthy T cells leads to fratricide of CD7-CAR T cells, requiring additional genetic modification. We took advantage of naturally occurring CD7- T cells to generate CD7-CAR (CD7-CARCD7-) T cells. CD7-CARCD7- T cells exhibited a predominantly CD4+ memory phenotype and had significant antitumor activity upon chronic antigen exposure in vitro and in xenograft mouse models. Based on these encouraging results, we next explored the utility of CD7- T cells for the immunotherapy of CD19+ hematological malignancies. Direct comparison of nonselected (bulk) CD19-CAR and CD19-CARCD7- T cells revealed that CD19-CARCD7- T cells had enhanced antitumor activity compared with their bulk counterparts in vitro and in vivo. Lastly, to gain insight into the behavior of CD19-CAR T cells with low levels of CD7 gene expression (CD7lo) in humans, we mined single-cell gene and T-cell receptor (TCR) expression data sets from our institutional CD19-CAR T-cell clinical study. CD19-CARCD7lo T cells were present in the initial CD19-CAR T-cell product and could be detected postinfusion. Intriguingly, the only functional CD4+ CD19-CAR T-cell cluster observed postinfusion exhibited CD7lo expression. Additionally, samples from patients responsive to therapy had a higher proportion of CD7lo T cells than nonresponders (NCT03573700). Thus, CARCD7- T cells have favorable biological characteristics and may present a promising T-cell subset for adoptive cell therapy of T-ALL and other hematological malignancies.
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