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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Identifying highly active anti-CCR4 CAR T cells for the treatment of T-cell lymphoma.
Identifying highly active anti-CCR4 CAR T cells for the treatment of T-cell lymphoma.
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CAR-T 治疗T细胞淋巴瘤的一项挑战是靶抗原常同时表达于正常T细胞和肿瘤细胞,可能导致CAR-T 相互杀伤以及对正常T细胞的靶向毒性。趋化因子受体CCR4在成人T细胞白血病/淋巴瘤(ATLL)及皮肤T细胞淋巴瘤(CTCL)等成熟T细胞恶性肿瘤中高表达,但在正常T细胞中分布特殊:主要见于Th2、Th17和Treg,在其他辅助T亚群及CD8细胞中少见。尽管通常认为CAR-T 相互杀伤不利于抗癌功能,本研究显示抗CCR4 CAR-T 可特异性清除Th2和Treg,同时保留CD8和Th1细胞;相互杀伤还提高最终产品中CAR阳性T细胞比例。CCR4 CAR-T 转导效率高、扩增强,并在转导扩增过程中快速清除CCR4阳性T细胞。以莫加珠单抗为基础构建的CCR4 CAR-T 在植入人T细胞淋巴瘤的小鼠中表现出更强抗肿瘤疗效和长期缓解。
总之,耗竭CCR4阳性细胞后的抗CCR4 CAR-T 富集Th1和CD8细胞,对CCR4表达型T细胞恶性肿瘤具有较强活性。
A challenge when targeting T-cell lymphoma with chimeric antigen receptor (CAR) T-cell therapy is that target antigens are often shared between T cells and tumor cells, resulting in fratricide between CAR T cells and on-target cytotoxicity on normal T cells. CC chemokine receptor 4 (CCR4) is highly expressed in many mature T-cell malignancies, such as adult T-cell leukemia/lymphoma (ATLL) and cutaneous T-cell lymphoma (CTCL), and has a unique expression profile in normal T cells.
CCR4 is predominantly expressed by type-2 and type-17 helper T cells (Th2 and Th17) and regulatory T cells (Treg), but it is rarely expressed by other T helper (Th) subsets and CD8+ cells. Although fratricide in CAR T cells is generally thought to be detrimental to anticancer functions, in this study, we demonstrated that anti-CCR4 CAR T cells specifically depleted Th2 and Tregs, while sparing CD8+ and Th1 T cells.
Moreover, fratricide increased the percentage of CAR+ T cells in the final product. CCR4-CAR T cells were characterized by high transduction efficiency, robust T-cell expansion, and rapid fratricidal depletion of CCR4-positive T cells during CAR transduction and expansion.
Furthermore, mogamulizumab-based CCR4-CAR T cells induced superior antitumor efficacy and long-term remission in mice engrafted with human T-cell lymphoma cells. In summary, CCR4-depleted anti-CCR4 CAR T cells are enriched in Th1 and CD8+ T cells and exhibit high antitumor efficacy against CCR4-expressing T-cell malignancies.
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