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:Generation of ex vivo autologous hematopoietic stem cell-derived T lymphocytes for cancer immunotherapy.
淋巴祖细胞分化后,CD5 + 和 CD7 + 细胞显著增加 (65-84 %),而 CD34 + 细胞随之下降。
CD19 CAR-T 细胞治疗复发/难治性 B 细胞恶性肿瘤显示出良好疗效,但对于经多线治疗的患者,T 细胞功能受限以及难以采集到适用于治疗的 T 细胞仍令人担忧。本研究考察生成造血干细胞来源 T 淋巴细胞(HSC-T)用于癌症免疫治疗的可行性。研究富集患者自体外周血中的 CD34+ 和 CD3+ 细胞,随后将 CD34+ 细胞依次经过淋巴祖细胞分化、T 细胞分化和 T 细胞成熟三个阶段培养。成功制备 HSC-T 细胞,扩增达 3,735 倍。淋巴祖细胞分化后,CD5+ 和 CD7+ 细胞显著增加(65%–84%),同时 CD34+ 细胞相应减少。第 42 天和第 52 天成熟 CD3+ 细胞比例分别达到 40% 和 90%。与 CD3-T 细胞相比,HSC-T 群体中初始表型占比更高(73% 对比 34%),CD8:CD4 比值为 2:1。激活后,HSC-T 细胞分泌的细胞因子和细胞毒性颗粒水平更高。评估其临床应用潜力发现,与对照 CAR-T 细胞相比,CD19CAR 转导的 HSC-T 细胞分泌细胞因子更多,对 CD19+ 靶细胞的细胞毒性也呈增强趋势。慢性抗原刺激实验显示,不同 CAR-T 细胞类型在 T 细胞增殖、干性和耗竭表型方面相似。总之,自体 HSC-T 可行制备且能保留 T 细胞效能,有望作为细胞免疫治疗的替代选择。
CD19CAR-T cell therapy demonstrated promising outcomes in relapsed/refractory B-cell malignancies. Nonetheless, the limited T-cell function and ineffective T-cell apheresis for therapeutic purposes are still concern in heavily pretreated patients. We investigated the feasibility of generating hematopoietic stem cell-derived T lymphocytes (HSC-T) for cancer immunotherapy. The patients' autologous peripheral blood HSCs were enriched for CD34 + and CD3 + cells. The CD34 + cells were then cultured following three steps of lymphoid progenitor differentiation, T-cell differentiation, and T-cell maturation processes. HSC-T cells were successfully generated with robust fold expansion of 3735 times. After lymphoid progenitor differentiation, CD5 + and CD7 + cells remarkably increased (65-84 %) while CD34 + cells consequentially declined. The mature CD3 + cells were detected up to 40 % and 90 % on days 42 and 52, respectively. The majority of HSC-T population was na ve phenotype compared to CD3-T cells (73 % vs 34 %) and CD8:CD4 ratio was 2:1. The higher level of cytokine and cytotoxic granule secretion in HSC-T was observed after activation. HSC-T cells were assessed for clinical application and found that CD19CAR-transduced HSC-T cells demonstrated higher cytokine secretion and a trend of superior cytotoxicity against CD19 + target cells compared to control CAR-T cells. A chronic antigen stimulation assay revealed similar T-cell proliferation, stemness, and exhaustion phenotypes among CAR-T cell types. In conclusions, autologous HSC-T was feasible to generate with preserved T-cell efficacy. The HSC-T cells are potentially utilized as an alternative option for cellular immunotherapy.
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