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:Rewiring endogenous genes in CAR T cells for tumour-restricted payload delivery.
Rewiring endogenous genes in CAR T cells for tumour-restricted payload delivery.
嵌合抗原受体(CAR)T 细胞疗法在实体瘤中的疗效受到免疫抑制和抗原异质性的限制 1-3。
嵌合抗原受体(CAR)T细胞疗法在实体瘤中的疗效受到免疫抑制和抗原异质性的限制1-3。为克服这些障碍,人们开发了可分泌促炎细胞因子的“装甲”CAR-T细胞4。然而,由于装甲转基因在外周表达所带来的毒性,其临床应用一直受限5。在此,我们开发了一种CRISPR敲入策略,利用内源基因的调控机制来驱动转基因以肿瘤局部化的方式表达。通过对具有肿瘤限制性表达的内源基因进行筛选,我们鉴定出NR4A2和RGS16启动子作为有前景的候选者,可支持将IL-12和IL-2等细胞因子直接递送至肿瘤部位,从而在同基因和异种模型中均增强了抗肿瘤疗效并延长了小鼠的长期生存。这一效应伴随着CAR-T细胞多功能性的改善、内源性抗肿瘤免疫的激活以及良好的安全性特征,并且适用于来自患者的CAR-T细胞。
The efficacy of chimeric antigen receptor (CAR) T cell therapy in solid tumours is limited by immunosuppression and antigen heterogeneity 1-3 . To overcome these barriers, 'armoured' CAR T cells, which secrete proinflammatory cytokines, have been developed 4 . However, their clinical application has been limited because of toxicity related to peripheral expression of the armouring transgene 5 . Here, we have developed a CRISPR knock-in strategy that leverages the regulatory mechanisms of endogenous genes to drive transgene expression in a tumour-localized manner. By screening endogenous genes with tumour-restricted expression, we have identified the NR4A2 and RGS16 promoters as promising candidates to support the delivery of cytokines such as IL-12 and IL-2 directly to the tumour site, leading to enhanced antitumour efficacy and long-term survival of mice in both syngeneic and xenogeneic models. This effect was concomitant with improved CAR T cell polyfunctionality, activation of endogenous antitumour immunity and a favourable safety profile, and was applicable in CAR T cells from patients.
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