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:Nonactivated and IL-7 cultured CD19-specific CAR T cells are enriched in stem cell phenotypes and functionally superior.
Nonactivated and IL-7 cultured CD19-specific CAR T cells are enriched in stem cell phenotypes and functionally superior.
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靶向CD19的嵌合抗原受体(CAR)T细胞在复发/难治性B细胞恶性肿瘤患者中取得了令人瞩目的缓解,但许多患者仍会复发或无应答,因此有必要提高疗效和持久性。目前制备CAR-T 细胞的方案通常通过CD3刺激激活T细胞,以促进CAR高效转导,随后在体外用外源性细胞因子扩增,达到治疗所需细胞数量。T细胞活化和扩增都会不可避免地导致终末分化及复制性衰老,不利于治疗。既往研究显示,白细胞介素7(IL-7)可在不活化T细胞的情况下实现慢病毒转导。
本研究使用IL-7,在不刺激CD3的情况下制备CD19 CAR-T 细胞。未活化、经IL-7培养的(NICE)CD19 CAR-T 细胞中,T记忆干细胞群富集,保留了新的干性标志物,耗竭标志物表达较低,增殖潜能更强。
此外,研究结果与NICE CAR-T 细胞成功植入相符,并显示其在腹腔内和皮下体内B细胞淋巴瘤模型中均具有更优治疗应答。这些结果提示,NICE CAR-T 细胞可能改善B细胞恶性肿瘤患者结局,值得开展临床评估。
CD19-specific chimeric antigen receptor (CAR) T cells have demonstrated impressive responses in patients with relapsed and refractory B cell malignancies.
However, many patients relapse or fail to respond to CD19 CAR T cells, demonstrating the need to improve its efficacy and durability. Current protocols for generating CAR T cells involve T cell activation through CD3 stimulation to facilitate efficient CAR transfer followed by ex vivo expansion with exogenous cytokines to obtain adequate cell numbers for treatment. Both T cell activation and expansion inevitably lead to terminal differentiation and replicative senescence, which are suboptimal for therapy.
Interleukin-7 (IL-7) was previously shown to allow for lentiviral transduction of T cells in the absence of activation. In these studies, we used IL-7 to generate CD19 CAR T cells without stimulating CD3. Nonactivated and IL-7 cultured (NICE) CD19 CAR T cells were enriched with the T memory stem cell population, retained novel markers of stemness, had lower expression of exhaustion markers, and increased proliferative potential.
Furthermore, our findings are consistent with engraftment of NICE CD19 CAR T cells and demonstrate a superior therapeutic response in both intraperitoneal and subcutaneous in vivo B cell lymphoma models. These results suggest that NICE CD19 CAR T cells may improve outcomes for B cell malignancies and warrant clinical evaluation.
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