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:Good manufacturing practice-grade generation of CD19 and CD123-specific CAR-T cells using piggyBac transposon and allogeneic feeder cells in patients diagnosed with B-cell non-Hodgkin lymphoma and acute myeloid leukemia.
所述方法能够以GMP兼容的方式生产足够数量的CAR19和CAR123 T细胞用于临床应用,并为可在早期临床试验中测试的新型实验性CAR-T细胞的非病毒制造提供了基础。该制造方法可补充并推进针对人类血液恶性肿瘤的新型实验性免疫治疗策略。
通过电穿孔转座子DNA质粒非病毒生产CAR-T细胞是慢病毒/逆转录病毒方法的替代方案。该方法特别适用于涉及新型CAR-T细胞的早期临床试验。非病毒方法的主要缺点是与病毒方法相比生产效率较低,这成为CAR-T生产的限制因素,尤其是在化疗预处理的淋巴细胞减少患者中。
我们描述了一种符合良好生产规范(GMP)的方案,用于基于转座子载体电穿孔生产CD19和CD123特异性CAR-T细胞。淋巴细胞从接受B-NHL或AML化疗的患者血液中纯化,并分别用电穿孔导入编码CAR19或CAR123的piggyBac转座子。随后,电穿孔后的细胞通过抗CD3/CD28抗体以及细胞因子组合(IL-4、IL-7、IL-21)进行多克隆激活。扩增在辐照过的同种异体血液来源单核细胞(即饲养层细胞)存在下进行,最长可达21天。
在饲养层存在下扩增提高了CAR-T产量(CAR19提高4.5倍,CAR123提高9.3倍)。详细的流式细胞术分析显示,在饲养层存在下生产后,早期记忆CAR-T细胞持续存在且载体拷贝数较低,对饲养层生产的CAR19和CAR123 T细胞的细胞毒性没有负面影响。此外,使用来自B-NHL患者的PBMC(起始数量=200x10e6细胞)在GMP条件下进行CAR19的大规模生产,在饲养层存在下,8例中有7例能够生产>50x10e6 CAR19,而在无饲养层的情况下,8例中仅有2例。
BACKGROUND: The non-viral production of CAR-T cells through electroporation of transposon DNA plasmids is an alternative approach to lentiviral/retroviral methods. This method is particularly suitable for early-phase clinical trials involving novel types of CAR-T cells. The primary disadvantage of non-viral methods is the lower production efficiency compared to viral-based methods, which becomes a limiting factor for CAR-T production, especially in chemotherapy-pretreated lymphopenic patients. METHODS: We describe a good manufacturing practice (GMP)-compliant protocol for producing CD19 and CD123-specific CAR-T cells based on the electroporation of transposon vectors. The lymphocytes were purified from the blood of patients undergoing chemotherapy for B-NHL or AML and were electroporated with piggyBac transposon encoding CAR19 or CAR123, respectively. Electroporated cells were then polyclonally activated by anti-CD3/CD28 antibodies and a combination of cytokines (IL-4, IL-7, IL-21). The expansion was carried out in the presence of irradiated allogeneic blood-derived mononuclear cells (i.e., the feeder) for up to 21 days. RESULTS: Expansion in the presence of the feeder enhanced CAR-T production yield (4.5-fold in CAR19 and 9.3-fold in CAR123). Detailed flow-cytometric analysis revealed the persistence of early-memory CAR-T cells and a low vector-copy number after production in the presence of the feeder, with no negative impact on the cytotoxicity of feeder-produced CAR19 and CAR123 T cells. Furthermore, large-scale manufacturing of CAR19 carried out under GMP conditions using PBMCs obtained from B-NHL patients (starting number=200x10e6 cells) enabled the production of >50x10e6 CAR19 in 7 out of 8 cases in the presence of the feeder while only in 2 out of 8 cases without the feeder. CONCLUSIONS: The described approach enables GMP-compatible production of sufficient numbers of CAR19 and CAR123 T cells for clinical application and provides the basis for non-viral manufacturing of novel experimental CAR-T cells that can be tested in early-phase clinical trials. This manufacturing approach can complement and advance novel experimental immunotherapeutic strategies against human hematologic malignancies.
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