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:CD19-immunoPET for noninvasive visualization of CD19 expression in B-cell lymphoma patients.
我们通过 CD19-immunoPET 在小鼠和人体内实现了对 CD19⁺ B-NHL 的特异性靶向与可视化。
靶向 CD19 的细胞疗法和抗体疗法治疗 B 细胞非霍奇金淋巴瘤(B-NHL)显示出巨大潜力,但所有方法均存在应答率有限和毒性显著的问题。迄今,治疗决策通常基于初诊或复发时单一病灶的 CD19 组织病理染色,未考虑抗原表达的异质性和时间变化。为无创显示体内 CD19 表达,研究者将抗人 CD19 单克隆抗体与铜-64(64Cu-αCD19)放射性标记,用于正电子发射断层扫描(CD19-immunoPET)。64Cu-αCD19 可在体内特异性结合皮下 Daudi 异种移植小鼠模型。重要的是,64Cu-αCD19 不影响体外 CD19 CAR-T 的抗淋巴瘤细胞毒作用。完成临床前验证后,研究向 4 例滤泡性淋巴瘤、弥漫性大 B 细胞淋巴瘤或套区淋巴瘤患者注射 64Cu-αCD19。患者不同淋巴瘤病灶内及患者之间均观察到不同的 64Cu-αCD19 PET 摄取模式,并与离体免疫组化 CD19 表达相关。此外,1 例患者脾脏摄取高于既往接受 B 细胞清除治疗的患者,提示 64Cu-αCD19 可用于识别富含 B 细胞的器官。总之,本研究展示 CD19-immunoPET 可在小鼠和人体内特异靶向并显示 CD19+ B-NHL。病灶内及患者间 64Cu-αCD19 摄取模式的异质性提示 CD19 表达存在差异,CD19-immunoPET 有望成为指导 CD19 靶向治疗的新工具。
Cell- and antibody-based CD19-directed therapies have demonstrated great potential for treating B-cell non-Hodgkin lymphoma (B-NHL). However, all these approaches suffer from limited response rates and considerable toxicity. Until now, therapy decisions have been routinely based on histopathological CD19 staining of a single lesion at initial diagnosis or relapse, disregarding heterogeneity and temporal alterations in antigen expression. To visualize in vivo CD19 expression noninvasively, we radiolabeled anti-human CD19 monoclonal antibodies with copper-64 ( 64 Cu- CD19) for positron emission tomography (CD19-immunoPET). 64 Cu- CD19 specifically bound to subcutaneous Daudi xenograft mouse models in vivo. Importantly, 64 Cu- CD19 did not affect the anti-lymphoma cytotoxicity of CD19 CAR-T cells in vitro. Following our preclinical validation, 64 Cu- CD19 was injected into four patients with follicular lymphoma, diffuse large B-cell lymphoma or mantle zone lymphoma. We observed varying 64 Cu- CD19 PET uptake patterns at different lymphoma sites, both within and among patients, correlating with ex vivo immunohistochemical CD19 expression. Moreover, one patient exhibited enhanced uptake in the spleen compared to that in patients with prior B-cell-depleting therapy, indicating that 64 Cu- CD19 is applicable for identifying B-cell-rich organs. In conclusion, we demonstrated the specific targeting and visualization of CD19 + B-NHL in mice and humans by CD19-immunoPET. The intra- and interindividual heterogeneous 64 Cu- CD19 uptake patterns of lymphoma lesions indicate variability in CD19 expression, suggesting the potential of CD19-immunoPET as a novel tool to guide CD19-directed therapies.
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