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:Inhibition of VEGF signaling prevents exhaustion and enhances anti-leukemia efficacy of CAR-T cells via Wnt/β-catenin pathway.
阿昔替尼通过调控 Wnt/β-catenin 信号通路,使 CAR-T 细胞抵抗耗竭。
背景:血液系统恶性肿瘤CAR-T细胞治疗面临的挑战包括T细胞耗竭和持续性不足,这些因素可导致癌症复发。方法:通过比较体外用阿昔替尼预处理的CAR-T细胞及B-ALL小鼠模型,研究VEGFR抑制剂阿昔替尼对CAR-T细胞体内外生物学功能的影响。采用实时定量PCR和蛋白质印迹检测CAR-T细胞中分化、耗竭及Wnt通路相关分子表达;通过流式细胞术评估分化、耗竭、活化、凋亡、增殖和细胞因子分泌变化。利用蛋白质印迹和流式细胞术检测VEGFR表达变化;通过生物发光成像、流式细胞术和免疫组化评估不同治疗小鼠的肿瘤负荷,并以苏木精-伊红染色监测小鼠肝脏和脾脏组织变化。结果:在持续性信号及肿瘤抗原暴露两种条件下,阿昔替尼均显著降低CAR-T细胞耗竭和终末分化。阿昔替尼预处理的CAR-T细胞体内抗肿瘤疗效增强并延长生存期。机制上,阿昔替尼上调CAR-T细胞Wnt/β-catenin信号通路。使用Wnt/β-catenin通路激动剂或抑制剂,分别可模拟或抵消阿昔替尼对CAR-T细胞耗竭及分化的影响。阿昔替尼处理的CAR-T细胞可抑制VEGFR2通路;使用抗VEGFR2抗体处理CAR-T细胞则可激活Wnt/β-catenin通路并防止细胞耗竭。结论:阿昔替尼通过调节Wnt/β-catenin信号通路,赋予CAR-T细胞抗耗竭能力。
BACKGROUND: Current challenges in Chimeric Antigen Receptor (CAR) -T cell therapy for hematological cancers include T cell exhaustion and limited persistence, which contribute to cancer relapse. METHODS: The effects of Axitinib, a VEGFR inhibitor, on the biological functions of CAR-T cells in vitro and in vivo were investigated by comparing CAR-T cells pre-treated ex vivo with Axitinib, as well as utilizing a B-ALL mouse model. Real-time quantitative PCR and Western blotting were employed to detect the expression of molecules related to differentiation, exhaustion, and the Wnt pathway in CAR-T cells. Flow cytometry was used to assess changes in CAR-T cell differentiation, exhaustion, activation, apoptosis, proliferation, and cytokine secretion. Western blotting and flow cytometry were used to assess changes in VEGFR expression. Bioluminescence imaging, flow cytometry, and immunohistochemistry (IHC) analysis were used to evaluate changes in tumor burden in mice receiving different treatments, while hematoxylin and eosin (H&E) staining were used to monitor histological changes in the liver and spleen of mice. RESULTS: Axitinib treatment notably reduced CAR-T cell exhaustion and terminal differentiation both under tonic signaling and tumor antigen exposure scenarios. Furthermore, CAR-T cells pretreated with Axitinib demonstrated enhanced anti-tumor efficacy and prolonged survival in vivo. Mechanistically, Axitinib treatment upregulated the Wnt/ -catenin signaling pathway in CAR-T cells. Using agonists/inhibitors of the Wnt/ -catenin pathway could respectively mimic or counteract the effects of Axitinib on CAR-T cell exhaustion and differentiation. CAR-T cells treated with Axitinib can inhibit the VEGFR2 pathway. CAR-T cells treated with anti-VEGFR2 antibody can activate the Wnt/ -catenin pathway and prevent CAR-T cell exhaustion. CONCLUSION: Axitinib confers resistance to exhaustion in CAR-T cells by modulating the Wnt/ -catenin signaling pathway.
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