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.
英文原题:HIV immune evasin Nef enhances allogeneic CAR T cell potency.
HIV immune evasin Nef enhances allogeneic CAR T cell potency.
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自体嵌合抗原受体(CAR)T细胞是一种基因工程疗法,对B细胞恶性肿瘤和多发性骨髓瘤高度有效1。然而,个性化生产的周期长和成本高限制了可及性,并使患者面临疾病进展的风险。同种异体细胞疗法有潜力提高患者的可及性并改善治疗结局,但受限于免疫排斥2,3。为设计一种保护同种异体CAR-T 细胞免受宿主免疫细胞攻击的策略,我们转向了嗜淋巴细胞病毒,这类病毒已进化出整合性的机制来实现对病毒感染淋巴细胞的免疫逃逸4。
我们发现,能够部分降低人类白细胞抗原I类表达的病毒逃逸蛋白可以保护CAR-T 细胞免受错配CD8+ T细胞的攻击,且不会引发NK 细胞的“缺失自我”排斥。
然而,仅靠这种保护不足以维持有效的同种异体CAR-T 细胞疗法。HIV-1 Nef还独特地通过丝氨酸/苏氨酸激酶Pak2发挥作用,减轻活化诱导的细胞死亡并促进CAR-T 细胞在体内的存活。
因此,类病毒免疫逃逸可借助多种协同作用的机制来增强同种异体CAR-T 细胞的治疗疗效。
Autologous chimeric antigen receptor (CAR) T cells are a genetically engineered therapy that is highly effective against B cell malignancies and multiple myeloma 1 .
However, the length and cost of personalized manufacturing limits access and leaves patients vulnerable to disease progression. Allogeneic cell therapies have the potential to increase patient access and improve treatment outcomes but are limited by immune rejection 2,3 . To devise a strategy to protect allogeneic CAR T cells from host immune cells, we turned to lymphotropic viruses that have evolved integrated mechanisms for immune escape of virus-infected lymphocytes 4 .
We find that viral evasins that partially reduce human leukocyte antigen class I expression can shelter CAR T cells from mismatched CD8 + T cells without triggering 'missing-self' rejection by natural killer cells.
However, this protection alone is insufficient to sustain effective allogeneic CAR T cell therapy. HIV-1 Nef uniquely also acts through the serine/threonine kinase Pak2 to abate activation-induced cell death and promote survival of CAR T cells in vivo.
Thus, virus-like immune escape can harness several mechanisms that act in concert to enhance the therapeutic efficacy of allogeneic CAR T cells.
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