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:Delineating MYC-Mediated Escape Mechanisms from Conventional and T Cell-Redirecting Therapeutic Antibodies.
MYC 高表达的肿瘤细胞通过几种互不重叠的机制削弱了治疗性抗体的疗效。
在B细胞恶性肿瘤中,MYC过表达与不良预后相关,但其介导免疫化疗耐药的机制尚不清楚。为进一步研究这一问题,我们发现,在多种淋巴瘤和多发性骨髓瘤细胞系以及患者来源的原发肿瘤细胞中,药理学抑制MYC可增强肿瘤细胞对NK细胞介导细胞毒作用的易感性。该作用由靶向CD20的传统抗体利妥昔单抗和靶向CD38的达雷妥尤单抗诱导,也能增强靶向CD19的双特异性T细胞衔接器(blinatumomab)诱导的T细胞介导细胞毒作用。除利妥昔单抗靶抗原CD20上调外,其他作用并不伴随靶抗原上调,提示存在额外的免疫逃逸机制。为探究这些机制,研究者使用CRISPR-Cas9基因编辑技术靶向OCI-LY18细胞中的MYC基因。CRISPR-Cas9介导的MYC靶向不仅上调CD20,还激活更广泛的凋亡通路:促凋亡蛋白PUMA上调,抗凋亡蛋白BCL-2、XIAP、survivin和MCL-1下调,从而使肿瘤细胞更易发生凋亡。凋亡是T细胞和NK细胞实现肿瘤裂解的关键机制。此外,MYC下调增强了blinatumomab诱导的T细胞活化和细胞因子释放,揭示了MYC介导的T细胞抑制机制。总之,MYC过表达肿瘤细胞通过多种互不重叠的机制削弱治疗性抗体疗效。鉴于直接抑制MYC存在毒性方面的挑战,成功调节MYC介导的免疫逃逸机制可能改善B细胞恶性肿瘤免疫治疗的结局。
In B-cell malignancies, the overexpression of MYC is associated with poor prognosis, but its mechanism underlying resistance to immunochemotherapy remains less clear. In further investigations of this issue, we show here that the pharmacological inhibition of MYC in various lymphoma and multiple myeloma cell lines, as well as patient-derived primary tumor cells, enhances their susceptibility to NK cell-mediated cytotoxicity induced by conventional antibodies targeting CD20 (rituximab) and CD38 (daratumumab), as well as T cell-mediated cytotoxicity induced by the CD19-targeting bispecific T-cell engager blinatumomab. This was associated with upregulation of the target antigen only for rituximab, suggesting additional escape mechanisms. To investigate these mechanisms, we targeted the MYC gene in OCI-LY18 cells using CRISPR-Cas9 gene-editing technology. CRISPR-Cas9-mediated MYC targeting not only upregulated CD20 but also triggered broader apoptotic pathways, upregulating pro-apoptotic PUMA and downregulating anti-apoptotic proteins BCL-2, XIAP, survivin and MCL-1, thereby rendering tumor cells more prone to apoptosis, a key tumor-lysis mechanism employed by T-cells and NK-cells. Moreover, MYC downregulation boosted T-cell activation and cytokine release in response to blinatumomab, revealing a MYC-mediated T-cell suppression mechanism. In conclusion, MYC overexpressing tumor cells mitigated the efficacy of therapeutic antibodies through several non-overlapping mechanisms. Given the challenges associated with direct MYC inhibition due to toxicity, successful modulation of MYC-mediated immune evasion mechanisms may improve the outcome of immunotherapeutic approaches in B-cell malignancies.
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