决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:A novel microenvironment regulated system CAR-T (MRS.CAR-T) for immunotherapeutic treatment of esophageal squamous carcinoma.
CAR-T 细胞免疫治疗在血液系统恶性肿瘤的治疗中已取得令人鼓舞的疗效。
CAR-T 细胞免疫治疗在血液系统恶性肿瘤治疗中已取得有希望的治疗效果。然而,仍有许多障碍,包括在靶脱瘤抗原表达,阻碍了其成功应用于实体瘤。我们设计了一种肿瘤微环境(TME)调控的CAR-T 系统(MRS.CAR-T),其只能在实体瘤 TME 中自动激活。选择 B7-H3 作为食管癌的靶抗原。将包含人血清白蛋白(HSA)结合肽和基质金属蛋白酶(MMPs)切割位点的元件插入 CAR 骨架的 5' 端信号肽与单链可变区片段(scFv)之间。给药后,HSA 有效结合 MRS.B7-H3.CAR-T 中的结合肽,并促进增殖和向记忆细胞分化。MRS.B7-H3.CAR-T 在表达 B7-H3 的正常组织中无细胞毒性,因为 scFv 中的抗原识别位点被 HSA 遮蔽。一旦 TME 中的 MMPs 切割该切割位点,MRS.B7-H3.CAR-T 的抗肿瘤功能即恢复。在体外,与经典 B7-H3.CAR-T 细胞相比,MRS.B7-H3.CAR-T 细胞相关的抗肿瘤疗效提高,且释放的 IFN-γ 更少,提示该治疗可能诱导较轻程度的细胞因子释放综合征介导的毒性。在体内,MRS.B7-H3.CAR-T 细胞具有强抗肿瘤活性且安全。MRS.CAR-T 代表一种提高实体瘤中 CAR-T 疗法疗效和安全性的新策略。
Chimeric antigen receptor T cell immunotherapy has achieved promising therapeutic effects in the treatment of hematological malignancies. However, there are still many obstacles, including on-target off-tumor antigen expression, that prevent successful application to solid tumors. We designed a tumor microenvironment (TME) regulated system chimeric antigen receptor T (MRS.CAR-T) which can only be auto-activated in the solid TME. B7-H3 was selected as the target antigen for esophageal carcinoma. An element comprising a human serum albumin (HSA) binding peptide and a matrix metalloproteases (MMPs) cleavage site was inserted between the 5' terminal signal peptide and single chain fragment variable (scFv) of the CAR skeleton. Upon administration, HSA bound the binding peptide in MRS.B7-H3.CAR-T effectively and promoted proliferation and differentiation into memory cells. MRS.B7-H3.CAR-T was not cytotoxic in normal tissues expressing B7-H3 as the antigen recognition site in the scFv was cloaked by HSA. The anti-tumor function of MRS.B7-H3.CAR-T was recovered once the cleavage site was cleaved by MMPs in the TME. The anti-tumor efficacy associated with MRS.B7-H3.CAR-T cells was improved compared to classic B7-H3.CAR-T cells in vitro and less IFN- was released, suggesting a treatment that may induce less extent of cytokine release syndrome-mediated toxicity. In vivo, MRS.B7-H3.CAR-T cells had strong anti-tumor activity and were safe. MRS.CAR-T represents a novel strategy to improve the efficacy and safety of CAR-T therapy in solid tumors.
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