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:Development of a microfluidic cell transfection device into gene-edited CAR T cell manufacturing workflow.
微流控方法实现了 >60% 的 CD5 编辑效率、80% 的细胞活力、与未处理细胞相似的记忆表型组成以及更优的细胞生长。
通过基因重编程使免疫细胞识别并靶向肿瘤细胞,为实现长期治愈提供了可能,但细胞治疗缺乏简单、经济的生产流程,尤其是对免疫细胞进行基因编辑以增强肿瘤靶向并避免免疫抑制机制方面。微流控技术有望提高基因修饰细胞生产的精确性,但尚未证实微流控处理能在完整流程中保留T细胞产品功能。本研究采用微流控技术利用CRISPR/Cas9敲除T细胞负调节因子CD5,随后通过慢病毒转导插入嵌合抗原受体(CAR)转基因,制备靶向B细胞抗原CD19的CAR-T细胞。研究优化了一种微流控装置,该装置利用细胞与周围液体间的对流体积交换,将向导RNA及Cas9核糖核蛋白递送至原代T细胞。研究全面测试装置的关键设计特征,以提高基因编辑产品产量。结合高速视频和原子力显微镜细胞力学测量,研究验证了装置设计参数与细胞特征之间的模型。通过聚焦细胞以抵消脊状狭窄结构产生的流动阻力、设计可提供足够压缩循环及体积恢复时间的脊状布局,并设置排液槽清除可能降低细胞活力的聚集体,可提升装置性能。优化装置用于制备CD5敲除CD19 CAR-T。微流控方法的CD5编辑效率超过60%,细胞活率为80%,所得细胞的记忆表型组成与未处理细胞相似,且细胞生长更佳。扩增后,微流控流程获得的编辑T细胞数量是电穿孔流程的4倍。转导后的CAR-T细胞具有相似转导效率,且对CD19阳性白血病细胞的细胞毒性相当。患者来源T细胞也可进行类似编辑,但其生物力学特性不同,导致编辑效果略低。微流控制造是提高基因编辑CAR-T细胞临床生产效率的有前景途径。
Genetic reprogramming of immune cells to recognize and target tumor cells offers a possibility of long-term cure. Cell therapies, however, lack simple and affordable manufacturing workflows, especially to genetically edit immune cells to more effectively target cancer cells and avoid immune suppression mechanisms. Microfluidics is a pathway to improve the manufacturing precision of gene modified cells. However, to date, it remains to be demonstrated that microfluidic treatment preserves the functionality of T cell products in a complete workflow. In this study, we used microfluidics to perform CRISPR/Cas9 gene editing of CD5, a negative T-cell regulator, followed by the insertion of a chimeric antigen receptor (CAR) transgene via lentiviral vector transduction to generate CAR T cells targeted against the B cell antigen CD19. As part of the workflow, we have optimized a microfluidic device that relies on convective volume exchange between cells and surrounding fluid to deliver guide RNA and Cas9 ribonucleoprotein to primary T cells. We comprehensively tested critical design features of the device to improve the gene-edited product yield. By combining high-speed video and cell mechanics measurements using the atomic force microscope, we validate a model that relates the device design features to cell properties. Our findings showed enhanced performance was obtained by focusing the cells to counteract the flow resistance caused by the ridge constrictions, providing a ridge layout that allows sufficient cycles of compression and time for volume recovery, and including a gutter to clear aggregates that could reduce cell viability. The optimized device was used in a workflow to generate CD5-knockout CD19 CAR T cells. The microfluidics approach resulted in >60% CD5 editing efficiency, 80% cell viability, similar memory phenotype composition as unprocessed cells, and superior cell growth. The microfluidics workflow yielded 4-fold increase of edited T cells compared to an electroporation workflow post-expansion. The transduced CAR T cells showed similar transduction efficiency and cytotoxicity against CD19-positive leukemia cells. Moreover, patient-derived T cells showed the ability to be similarly edited, though their distinct biomechanics resulted in slightly lower outcomes. Microfluidics-based manufacturing is a promising path towards more productive clinical manufacturing of gene edited CAR T cells.
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