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:A bioengineered immunocompetent human leukemia chip for preclinical screening of CAR T cell immunotherapy.
A bioengineered immunocompetent human leukemia chip for preclinical screening of CAR T cell immunotherapy.
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嵌合抗原受体(CAR)T 细胞免疫疗法治疗血液系统肿瘤前景良好,但临床获益难以预测,因此需要开发最佳 CAR-T 细胞产品。遗憾的是,当前临床前评估平台与人体生理相关性有限,难以满足这一需求。我们设计了一种器官型免疫芯片,重现人类白血病骨髓基质和免疫生态位的微观结构及病理生理特征,用于 CAR-T 细胞疗法建模。该白血病芯片可实时监测 CAR-T 细胞功能的时空变化,包括 T 细胞外渗、白血病识别、免疫活化、细胞毒作用和杀伤。随后,我们在芯片上模拟并绘制 CAR-T 治疗后的不同反应,包括临床观察到的缓解、耐药和复发,并鉴定可能导致治疗失败的因素。最后,我们开发了基于基质的分析整合指标,用于区分健康供者和患者来源、采用不同 CAR 设计和代次的 CAR-T 细胞功能表现。总之,该芯片提供了一种可用于 CAR-T 细胞开发的“(临床前)芯片临床试验”工具,有望推动个体化治疗并改善临床决策。
Chimeric antigen receptor (CAR) T cell immunotherapy is promising for treatment of blood cancers; however, clinical benefits remain unpredictable, necessitating development of optimal CAR T cell products. Unfortunately, current preclinical evaluation platforms are inadequate due to their limited physiological relevance to humans.
We herein engineered an organotypic immunocompetent chip that recapitulates microarchitectural and pathophysiological characteristics of human leukemia bone marrow stromal and immune niches for CAR T cell therapy modeling. This leukemia chip empowered real-time spatiotemporal monitoring of CAR T cell functionality, including T cell extravasation, recognition of leukemia, immune activation, cytotoxicity, and killing.
We next on-chip modelled and mapped different responses post CAR T cell therapy, i. e. , remission, resistance, and relapse as observed clinically and identify factors that potentially drive therapeutic failure.
Finally, we developed a matrix-based analytical and integrative index to demarcate functional performance of CAR T cells with different CAR designs and generations produced from healthy donors and patients.
Together, our chip introduces an enabling '(pre-)clinical-trial-on-chip' tool for CAR T cell development, which may translate to personalized therapies and improved clinical decision-making.
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