← 返回

中和 IFN-γ 提高 B 细胞恶性肿瘤中 CAR-T 细胞治疗的安全性而不损害疗效

英文原题:Neutralizing IFNγ improves safety without compromising efficacy of CAR-T cell therapy in B-cell malignancies.

查看英文原题

Neutralizing IFNγ improves safety without compromising efficacy of CAR-T cell therapy in B-cell malignancies.

PubMed 2023/06/09(内容时间) Nat Commun Q1 · IF 18.1(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

中文摘要

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。

展开英文摘要原文

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.

论文信息

作者
Manni S、Del Bufalo F、Merli P、Silvestris DA、Guercio M、Caruso S、Reddel S、Iaffaldano L
第一作者单位
Department of Haematology-Oncology and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.Italy
通讯作者单位
Department of Haematology-Oncology and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy. franco.locatelli@opbg.net.Italy
文献类型
非美国政府资助研究
期刊
Nature communications2023 Jun 9
原文标识
PubMed 37296093 · DOI 10.1038/s41467-023-38723-y