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:Expression of VISTA regulated via IFN-γ governs endogenous T-cell function and exhibits correlation with the efficacy of CD19 CAR-T cell treated B-malignant mice.
我们的发现证实,内源性 T 细胞活化与功能受 VISTA 调控,VISTA 与 CAR-T 的治疗效果相关,并为 CAR-T 治疗中的复发患者提供了一种有前景的治疗策略。
尽管CAR结构和靶点不断改进,治疗后复发仍是重要挑战,肿瘤微环境与疗效密切相关。T细胞活化V结构域免疫球蛋白抑制因子VISTA在微环境调控中作用复杂,既可作为抗原呈递细胞配体,也可作为T细胞受体;其如何调控内源性T细胞活化尚未充分阐明。本研究在B细胞急性淋巴细胞白血病、淋巴瘤和黑色素瘤小鼠模型中,考察CD19及人碳酸酐酶IX CAR-T治疗后的内源性T细胞,并研究干扰素信号调节VISTA的作用。CAR-T治疗可增强肿瘤微环境内源性T细胞反应;若缺乏干扰素信号,VISTA水平持续升高,内源性T细胞杀伤减弱,白血病小鼠生存下降。缓解期内源性记忆T细胞增加,并可响应肿瘤、抵御再次攻击。阻断VISTA可增强树突状细胞诱导的同系T细胞增殖及细胞因子产生。结果表明VISTA调节内源性T细胞功能并与CAR-T疗效相关,可能为预防复发提供治疗策略。
BACKGROUND: Despite continuous improvements in the new target and construction of chimeric antigen receptor (CAR)-T, relapse remains a significant challenge following CAR-T therapy. Tumor microenvironment (TME) strongly correlates with the efficacy of CAR-T therapy. V-domain Ig suppressor of T-cell activation (VISTA), which exerts a multifaceted and controversial role in regulating the TME, acts not only as a ligand on antigen-presenting cells but also functions as a receptor on T cells. However, the characteristics and underlying mechanisms governing endogenous T-cell activation by VISTA, which are pivotal for reshaping the TME, remain incompletely elucidated. METHODS: The immunocompetent B acute lymphoblastic leukemia (B-ALL), lymphoma, and melanoma murine models were employed to investigate the characteristics of endogenous T cells within the TME following CD19 and hCAIX CAR-T cell therapy, respectively. Furthermore, we examined the role of VISTA controlled by interferon (IFN)- signaling in regulating endogenous T-cell activation and functionality in B-ALL mice. RESULTS: We demonstrated that the administration of CD19 CAR-T or hCAIX CAR-T cell therapy elicited augmented immune responses of endogenous T cells within the TME of B-ALL, lymphoma, and melanoma mice, thereby substantiating the efficacy of CAR-T cell efficacy. However, in the TME lacking IFN- signaling, VISTA levels remained elevated, resulting in attenuated cytotoxicity of endogenous T cells and reduced B-ALL recipient survival. Mice treated with CD19 CAR-T cells exhibited increased proportions of endogenous memory T cells during prolonged remission, which possessed the tumor-responsive capabilities to protect against B-ALL re-challenge. Compared with wild-type (WT) CAR-T treated mice, the administration of IFN- -/- CAR-T to both WT and IFN- -/- recipients resulted in a reduction in the numbers of endogenous CD4 + and CD8 + effectors, while exhibiting increased populations of na ve-like CD4 + T and memory CD8 + T cells. VISTA expression consistently remained elevated in resting or memory CD4 + T cells, with distinct localization from programmed cell death protein-1 (PD-1) expressing T subsets. Blocking the VISTA signal enhanced dendritic cell-induced proliferation and cytokine production by syngeneic T cells. CONCLUSION: Our findings confirm that endogenous T-cell activation and functionality are regulated by VISTA, which is associated with the therapeutic efficiency of CAR-T and provides a promising therapeutic strategy for relapse cases in CAR-T therapy.
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