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:Improving CAR-T cell function through a targeted cytokine delivery system utilizing car target-modified extracellular vesicles.
这些数据表明,CAR 靶向的修饰 EVs 可作为 CAR-T 细胞的靶向细胞因子递送系统,为增强 CAR-T 细胞功能提供了一种安全有效的策略。
CAR-T 治疗 B 细胞恶性肿瘤已取得显著临床成功,但某些病例的疗效受 T 细胞持久性差和抗肿瘤活性不足限制。此外,IL-12 是癌症免疫治疗的重要药物,但全身暴露相关严重毒性限制了其临床应用。本研究开发了一种新型细胞因子递送平台,利用 CAR 靶点修饰的细胞来源 EV 优先结合 CAR-T,以改善其功能。研究者成功利用 HEK-293T 细胞制备表面展示 CD19 和/或 IL-12 的 EV。与等浓度重组人 IL-12 相比,IL-12 EV 在体外显著增强抗 CD19 CAR-T 效应功能,增加 IFN-γ 和 TNF-α 分泌、细胞毒活性及 T 细胞扩增。此外,与仅表达 IL-12 的 EV 相比,同时表达 IL-12 和 CD19 的 EV(CD19/IL-12 EV)与 CAR-T 的结合效率更高,但与普通 T 细胞结合较少,流式细胞术证实了这一点。在携带 CD19⁺ Raji 肿瘤的异种移植小鼠模型中,瘤内注射 CD19/IL-12 EV 可产生持久抗肿瘤应答,并增强 CAR-T 体内扩增;疗效优于 CD19 EV、IL-12 EV 和对照 EV,且未引起全身毒性。对 EV 刺激 CAR-T 的 RNA 测序分析提示,疗效增强由 IL-12 信号驱动。数据表明,CAR 靶向修饰 EV 可作为 CAR-T 靶向细胞因子递送系统,为安全有效增强 CAR-T 功能提供策略。
Chimeric antigen receptor (CAR)-T-cell therapy has achieved remarkable clinical success in the treatment of B-cell malignancies; however, its efficacy can be limited by poor T-cell persistence and insufficient antitumor activity in certain cases. Moreover, interleukin-12 (IL-12) is a prominent agent in cancer immunotherapy, but its clinical application is constrained by severe toxicity associated with systemic exposure. In this study, we developed a novel cytokine delivery platform based on CAR target-modified cell-derived extracellular vesicles (EVs) that preferentially bind CAR-T cells to improve CAR-T-cell function. EVs with surface-displayed CD19 and/or IL-12 were successfully generated from HEK-293T cells. Compared with an equivalent concentration of rhIL-12, IL-12 EVs significantly enhanced the effector function of anti-CD19 CAR-T cells in vitro, resulting in increased Interferon- (IFN- ) and TNF- secretion, cytolytic activity, and T-cell expansion. Additionally, compared with EVs expressing IL-12 alone, EVs co-expressing IL-12 and CD19 (CD19/IL-12 EVs) exhibited superior binding efficiency to CAR-T cells but not to T cells, as indicated by flow cytometry. In xenograft model mice bearing CD19 + Raji tumors, intratumoral injection of CD19/IL-12 EVs resulted in durable antitumor responses and enhanced the in vivo expansion of CAR-T cells, outperforming CD19 EVs, IL-12 EVs and control EVs, without causing systemic toxicity. RNA sequencing (RNA-seq) analysis of CAR-T cells stimulated with EVs suggested that the increased efficacy was driven by IL-12 signaling. These data demonstrate that CAR-targeted modified EVs may serve as targeted cytokine delivery systems for CAR-T cells, offering a safe and effective strategy to augment CAR-T-cell function.
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