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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Neutralizing IFNγ improves safety without compromising efficacy of CAR-T cell therapy in B-cell malignancies.
Neutralizing IFNγ improves safety without compromising efficacy of CAR-T cell therapy in B-cell malignancies.
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CAR-T(CAR-T)细胞疗法可能使对常规治疗无反应的B细胞恶性肿瘤患者获得持久缓解。然而,潜在的严重且难以管理的副作用,包括细胞因子释放综合征(CRS)、神经毒性和巨噬细胞活化综合征,以及缺乏病理生理学实验模型,限制了这种疗法的适用性和发展。
在此,我们提出了一种全面的拟人化小鼠模型,通过该模型我们表明,使用临床批准的单克隆抗体emapalumab中和IFN可减轻与CAR-T 细胞疗法相关的严重毒性。
我们证明emapalumab减少了模型中的促炎环境,从而能够控制严重的CRS并防止以多灶性出血为特征的大脑损伤。重要的是,我们的体外和体内实验表明,IFN抑制不影响靶向CD19的CAR-T(CAR.CD19-T)细胞根除CD19+淋巴瘤细胞的能力。
因此,我们的研究提供了证据,表明抗IFN治疗可能减少免疫相关不良反应而不影响治疗成功,并为在人类中进行emapalumab-CAR.CD19-T细胞联合治疗提供了依据。
Chimeric antigen receptor T (CAR-T) cell therapy may achieve long-lasting remission in patients with B-cell malignancies not responding to conventional therapies.
However, potentially severe and hard-to-manage side effects, including cytokine release syndrome (CRS), neurotoxicity and macrophage activation syndrome, and the lack of pathophysiological experimental models limit the applicability and development of this form of therapy.
Here we present a comprehensive humanized mouse model, by which we show that IFN neutralization by the clinically approved monoclonal antibody, emapalumab, mitigates severe toxicity related to CAR-T cell therapy.
We demonstrate that emapalumab reduces the pro-inflammatory environment in the model, thus allowing control of severe CRS and preventing brain damage, characterized by multifocal hemorrhages.
Importantly, our in vitro and in vivo experiments show that IFN inhibition does not affect the ability of CD19-targeting CAR-T (CAR. CD19-T) cells to eradicate CD19+ lymphoma cells.
Thus, our study provides evidence that anti-IFN treatment might reduce immune related adverse effect without compromising therapeutic success and provides rationale for an emapalumab-CAR. CD19-T cell combination therapy in humans.
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