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:Hypoimmune anti-CD19 chimeric antigen receptor T cells provide lasting tumor control in fully immunocompetent allogeneic humanized mice.
这些发现提示,通用型异体 HIP CAR T 细胞疗法可能克服异体 CAR T 细胞持久性差所带来的局限,并产生持久的抗肿瘤应答。
自体CAR-T生产复杂,许多患者因此延迟治疗或无法接受治疗。异基因CAR产品有望突破制造瓶颈,但会被宿主免疫排斥且难以持续,疗效不及自体产品。本研究旨在开发可逃避免疫识别并产生持久反应的通用异基因CAR-T。采用CRISPR-Cas9破坏B2M、CIITA和TRAC基因,制备人低免疫原性(HIP)T细胞;同时通过慢病毒表达CD47及抗CD19 CAR。将HIP CD19 CAR-T与仅表达抗CD19 CAR的异基因CAR-T比较。体外杀瘤和耗竭实验未发现两组差异,说明HIP编辑未损害T细胞功能;在免疫缺陷NSG小鼠中清除CD19阳性肿瘤的能力也相近。在完全免疫健全的人源化小鼠中,HIP CAR-T显著优于普通异基因CAR-T,扩增及持续性更佳并实现持久肿瘤清除。此外,针对CD47的安全开关策略可可靠且特异地清除HIP CAR-T。结果提示,通用型异基因HIP CAR-T可能克服持续性不足问题并产生持久抗肿瘤反应。
Manufacturing autologous chimeric antigen receptor (CAR) T cell therapeutics is complex, and many patients experience treatment delays or cannot be treated at all. Although current allogeneic CAR products have the potential to overcome manufacturing bottlenecks, they are subject to immune rejection and failure to persist in the host, and thus do not provide the same level of efficacy as their autologous counterparts. Here, we aimed to develop universal allogeneic CAR T cells that evade the immune system and produce a durable response. We generated human hypoimmune (HIP) T cells with disrupted B2M, CIITA, and TRAC genes using CRISPR-Cas9 editing. In addition, CD47 and anti-CD19 CAR were expressed using lentiviral transduction. These allogeneic HIP CD19 CAR T cells were compared to allogeneic CD19 CAR T cells that only expressed the anti-CD19 CAR (allo CAR T). In vitro assays for cancer killing and exhaustion revealed no differences between allo CAR T and HIP CAR T cells, confirming that the HIP edits did not negatively affect T cell performance. Clearance of CD19 + tumors by HIP CAR T cells in immunodeficient NSG mice was comparable to that of allo CAR T cells. In fully immunocompetent humanized mice, HIP CAR T cells significantly outperformed allo CAR T cells, showed improved persistence and expansion, and provided lasting cancer clearance. Furthermore, CD47-targeting safety strategies reliably and specifically eliminated HIP CAR T cells. These findings suggest that universal allogeneic HIP CAR T cell-based therapeutics might overcome the limitations associated with poor persistence of allogeneic CAR T cells and exert durable anti-tumor responses.
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