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:A chimeric antigen receptor-based cellular safeguard mechanism for selective in vivo depletion of engineered T cells.
A chimeric antigen receptor-based cellular safeguard mechanism for selective in vivo depletion of engineered T cells.
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基于嵌合抗原受体(CAR)工程化T细胞的过继免疫治疗在治疗B细胞恶性肿瘤方面已展现出令人瞩目的临床疗效。然而,当靶抗原与健康细胞共享时,CAR-T 细胞携带的效力可能导致显著的on-target/off-tumor毒性,因此需要开发互补的安全措施。
在此背景下,需要选择性消除治疗性输入的CAR-T 细胞,尤其是为了逆转长期CAR-T 细胞相关副作用。为解决这一问题,我们开发了一种有效的基于细胞的安全机制,能够特异性靶向并消除输入的CAR-T 细胞。作为原理验证,我们设计了一种次级CAR(anti-CAR CAR),能够识别整合到anti-CD19 CAR铰链区中的短肽序列(Strep-tag II)。在体外实验中,这些anti-CAR CAR-T 细胞在与anti-CD19 CAR-T 细胞共培养时表现出抗原特异性细胞因子释放和细胞毒性。
此外,在免疫缺陷和免疫健全小鼠中,我们观察到当与anti-CAR CAR-T 细胞同时给药时,anti-CD19 CAR-T 细胞被成功清除。
我们还在CD19 CAR治疗诱导的B细胞再生障碍这一临床相关动物模型中证明了该保障机制的有效性,其中该副作用在输注anti-CAR CAR-T 细胞后被逆转。
值得注意的是,即使在anti-CAR CAR-T 细胞输注前没有任何预处理方案的情况下,也实现了高效的B细胞恢复,从而增强了其实际适用性。
总之,我们开发了一种稳健的细胞安全系统,用于在体内选择性清除工程化T细胞,为解决CAR-T 细胞相关的on-target/off-tumor毒性提供了一种有前景的解决方案。
Adoptive immunotherapy based on chimeric antigen receptor (CAR)-engineered T cells has exhibited impressive clinical efficacy in treating B-cell malignancies.
However, the potency of CAR-T cells carriethe potential for significant on-target/off-tumor toxicities when target antigens are shared with healthy cells, necessitating the development of complementary safety measures. In this context, there is a need to selectively eliminate therapeutically administered CAR-T cells, especially to revert long-term CAR-T cell-related side effects.
To address this, we have developed an effective cellular-based safety mechanism to specifically target and eliminate the transferred CAR-T cells. As proof-of-principle, we have designed a secondary CAR ( anti -CAR CAR) capable of recognizing a short peptide sequence (Strep-tag II) incorporated into the hinge domain of an anti -CD19 CAR. In in vitro experiments, these anti -CAR CAR-T cells have demonstrated antigen-specific cytokine release and cytotoxicity when co-cultured with anti -CD19 CAR-T cells.
Moreover, in both immunocompromised and immunocompetent mice, we observed the successful depletion of anti -CD19 CAR-T cells when administered concurrently with anti -CAR CAR-T cells.
We have also demonstrated the efficacy of this safeguard mechanism in a clinically relevant animal model of B-cell aplasia induced by CD19 CAR treatment, where this side effect was reversed upon anti -CAR CAR-T cells infusion.
Notably, efficient B-cell recovery occurred even in the absence of any pre-conditioning regimens prior anti -CAR CAR-T cells transfer, thus enhancing its practical applicability. In summary, we developed a robust cellular safeguard system for selective in vivo elimination of engineered T cells, offering a promising solution to address CAR-T cell-related on-target/off-tumor toxicities.
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