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:Placental circulating T cells: a novel, allogeneic CAR-T cell platform with preserved T-cell stemness, more favorable cytokine profile, and durable efficacy compared to adult PBMC-derived CAR-T.
Placental circulating T cells: a novel, allogeneic CAR-T cell platform with preserved T-cell stemness, more favorable cytokine profile, and durable efficacy compared to adult PBMC-derived CAR-T.
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我们鉴定出富集于 P-T CD19 CAR-T 中的 T 细胞干性特征,这些特征在 PBMC 来源的产品中缺失,并在体内转化为缓解的持久性。
嵌合抗原受体(CAR)T 细胞质量和干性与应答、持久性及记忆形成相关,有利于临床疗效。不同癌症患者自体 T 细胞起始材料差异较大,CAR-T 扩增或效力可能在生产过程中失败。因此,开发异基因 CAR-T 平台、识别并扩增与 CAR-T 效力相关的 T 细胞亚群,已成为积极研究方向。本研究比较由健康成人外周血 T 细胞和胎盘循环 T(P-T)细胞制备的 CAR-T。
采用相同方案,由健康成人外周血单个核细胞(PBMC)和 P-T 细胞制备 CAR-T。结合多参数流式细胞术、功能实验和 RNA 测序对 CAR-T 进行详细表征。在 Daudi 淋巴瘤异种移植模型中评估 CAR-T 的体内抗肿瘤疗效和持久性。
与成人 PBMC 来源 T 细胞相比,P-T 细胞具有干性优势:培养开始前均为初始型,端粒较长,较能抵抗免疫检查点上调,且在 CD19 CAR-T 制备过程中较少进一步分化。P-T CD19 CAR-T 的细胞毒性与 PBMC-CD19 CAR-T 相当,但对淋巴瘤的 IFN-γ 产生较少。转录组分析显示,P-T CD19 CAR-T 保留干样基因特征,与初始 T 细胞特征、早期记忆表型和独特 CD4 T 细胞特征密切相关;相比之下,PBMC-CD19 CAR-T 富集了耗竭和刺激后记忆 T 细胞特征。与功能数据一致,P-T CD19 CAR-T 炎症细胞因子和趋化因子基因特征较弱。在小鼠体内模型中,P-T CD19 CAR-T 可清除淋巴瘤,疗效超过 90 天;PBMC-CD19 CAR-T 仅带来非持久获益,并延缓疾病起病。
研究发现 P-T CD19 CAR-T 富含 PBMC 来源产品所缺乏的 T 细胞干性特征,并可转化为体内持久应答。本研究显示胎盘循环 T 细胞是异基因 CAR-T 产品的有价值来源,其固有的干性优势可带来更强体内持久性和长期疗效。
Chimeric antigen receptor (CAR)-T cell quality and stemness are associated with responsiveness, durability, and memory formation, which benefit clinical responses. Autologous T cell starting material across patients with cancer is variable and CAR-T expansion or potency can fail during manufacture. Thus, strategies to develop allogeneic CAR-T platforms including the identification and expansion of T cell subpopulations that correspond with CAR-T potency are an active area of investigation. Here, we compared CAR-T cells generated from healthy adult peripheral blood T cells versus placental circulating T (P-T) cells.
CAR-T cells from healthy adult peripheral blood mononuclear cells (PBMCs) and P-T cells were generated using the same protocol. CAR-T cells were characterized in detail by a combination of multiparameter flow cytometry, functional assays, and RNA sequencing. In vivo antitumor efficacy and persistence of CAR-T cells were evaluated in a Daudi lymphoma xenograft model.
P-T cells possess stemness advantages compared with T cells from adult PBMCs. P-T cells are uniformly na ve prior to culture initiation, maintain longer telomeres, resist immune checkpoint upregulation, and resist further differentiation compared with PBMC T cells during CD19 CAR-T manufacture. P-T CD19 CAR-T cells are equally cytotoxic as PBMC-CD19 CAR-T cells but produce less interferon gamma in response to lymphoma. Transcriptome analysis shows P-T CD19 CAR-T cells retain a stem-like gene signature, strongly associate with na ve T cells, an early memory phenotype, and a unique CD4 T cell signature compared with PBMC-CD19 CAR-T cells, which enrich for exhaustion and stimulated memory T cell signatures. Consistent with functional data, P-T CD19 CAR-T cells exhibit attenuated inflammatory cytokine and chemokine gene signatures. In a murine in vivo model, P-T CD19 CAR-T cells eliminate lymphoma beyond 90 days. PBMC-CD19 CAR-T cells provide a non-durable benefit, which only delays disease onset.
We identified characteristics of T cell stemness enriched in P-T CD19 CAR-T which are deficient in PBMC-derived products and translate into response durability in vivo. Our findings demonstrate that placental circulating T cells are a valuable cell source for allogeneic CAR-T products. Stemness advantages inherent to P-T cells translate to in vivo persistence advantages and long-term durable activity.
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