CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Low-Strength Type I Interferon Signaling Promotes CAR T-Cell Treatment Efficacy.
Low-Strength Type I Interferon Signaling Promotes CAR T-Cell Treatment Efficacy.
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靶向CD19的嵌合抗原受体(CAR)T细胞疗法显著拓展了复发/难治性弥漫性大B细胞淋巴瘤(r/r DLBCL)的治疗选择。
然而,多达60%的患者无法获得完全缓解。为揭示疗效决定因素,我们对8例临床应答不同的r/r DLBCL患者接受阿基仑赛治疗时的输注产品进行了单细胞转录组分析。与疾病进展患者相比,完全应答者输注产品中I型干扰素(IFN-I)信号特征富集。基于这些发现,我们提出一种新策略:在体外生产过程中将IFN-I作为增强因子,以提高靶向CD19的CAR-T 细胞治疗效能。对于采用CD28或4-1BB共刺激的第二代CAR,低强度IFN-I信号均可增强CAR-T 细胞细胞毒性和体内疗效;相反,高强度IFN-I信号会损害细胞活力和体内疗效。
我们的低强度IFN-I信号策略利用现有FDA批准的药物,并兼容当前CAR构型和生产流程。总之,研究结果确立IFN-I是一种强效且不依赖共刺激的CAR-T 疗效增强因子,并提供一种可转化至临床的策略,以增强r/r DLBCL的CAR-T 细胞疗法。
CD19-directed chimeric antigen receptor (CAR) T-cell therapy has significantly advanced the treatment landscape for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL).
However, up to 60% of patients do not achieve a complete response. To uncover determinants of therapeutic efficacy, we analyzed the infusion products of eight r/r DLBCL patients with distinct clinical responses to axicabtagene ciloleucel using single-cell transcriptomics. Compared to patients who exhibited progressive disease, infusion products of complete responders demonstrated enriched signatures of type I interferon (IFN-I) signaling.
Based on these findings, we developed a novel strategy to improve CD19-directed CAR T-cell treatment efficacy by incorporating IFN-I as an enhancer during the ex vivo manufacturing process. For both CD28- and 4-1BB-costimulated second-generation CARs, we found that low-strength IFN-I signaling enhanced CAR T-cell cytotoxicity and in vivo efficacy. On the other hand, high-strength IFN-I signaling compromised cell viability and in vivo efficacy.
Our low-strength IFN-I signaling approach leverages an existing FDA-approved pharmacologic agent and is compatible with current CAR constructs and manufacturing workflows.
Together, our results establish IFN-I as a potent and costimulation-independent enhancer of CAR T-cell efficacy and provide a translationally feasible approach to enhance CAR T-cell therapies for r/r DLBCL.
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