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:IRF4 downregulation improves sensitivity and endurance of CAR T cell functional capacities.
IRF4 downregulation improves sensitivity and endurance of CAR T cell functional capacities.
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嵌合抗原受体(CAR)修饰T细胞可使晚期血液系统恶性肿瘤患者获得完全缓解,但疗效多数是暂时的,治疗实体瘤的效果目前仍较差。CAR-T 细胞实现长期疗效的关键障碍之一,是功能能力丧失,即“耗竭”。为延长CAR-T 细胞功能,研究人员使用单载体系统降低CAR-T 细胞中干扰素调节因子4(IRF4)水平;该系统编码特异性短发夹RNA,同时持续表达CAR。基线条件下,IRF4下调的CAR-T 细胞与常规CAR-T 细胞具有相同的细胞毒性和细胞因子释放能力。但在反复遇到抗原的条件下,与常规CAR-T 细胞相比,IRF4低表达CAR-T 细胞功能更强,长期控制癌细胞的效果更好。
从机制上看,CAR-T 细胞中IRF4下调可延长其功能维持时间并上调CD27。此外,IRF4低表达CAR-T 细胞对低水平表达靶抗原的癌细胞更加敏感。
总体而言,下调IRF4可增强CAR-T 细胞识别和应答靶细胞的敏感性及持久性。
Chimeric antigen receptor (CAR) modified T cells can induce complete remissions in patients with advanced hematological malignancies. Nevertheless, the efficacy is mostly transient and remains so far poor in the treatment of solid tumors. Crucial barriers to long-term CAR T cell success encompass loss of functional capacities known as "exhaustion", among others.
To extend CAR T cell functionality, we reduced interferon regulatory factor 4 (IRF4) levels in CAR T cells using a one-vector system encoding a specific short-hairpin (sh) RNA along with constitutive CAR expression. At baseline, CAR T cells with downregulated IRF4 showed equal cytotoxicity and cytokine release compared to conventional CAR T cells.
However, under conditions of repetitive antigen encounter, IRF4 low CAR T cells displayed enhanced functionality with superior cancer cell control in the long-term compared with conventional CAR T cells.
Mechanistically, the downregulation of IRF4 in CAR T cells resulted in prolonged functional capacities and upregulation of CD27.
Moreover, IRF4 low CAR T cells were more sensitive to cancer cells with low levels of target antigen.
Overall, IRF4 downregulation capacitates CAR T cells to recognize and respond to target cells with improved sensitivity and endurance.
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