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:Multiplex engineering using microRNA-mediated gene silencing in CAR T cells.
通过靶向 miRNA 实现的可滴定多重基因沉默为 CAR T 细胞提供了基因编辑之外的替代方案,在效力、持久性、转移预防和免疫逃逸方面对异体产品具有潜在优势。
背景:多重基因编辑嵌合抗原受体(CAR)T细胞疗法面临重大挑战,包括DNA双链断裂相关的潜在致癌风险。靶向微小RNA(miRNA)可能提供更安全、有效且可调控的替代方法,在不编辑DNA的情况下实现基因沉默。 方法:为验证多基因沉默的可行性,我们采用优化的miRNA骨架和基因结构,在靶向间皮素的CAR(M5CAR)T细胞中沉默T细胞受体(TCR)和主要组织相容性复合体I类(MHC-I)。并将此方法与CRISPR/Cas9敲除CD3和β2-微球蛋白(β2M)的细胞进行比较。将表达miRNA的表达盒整合至M5CAR慢病毒载体,实现基因沉默与CAR表达联合。利用体外实验和胰腺导管腺癌体内模型评估抗肿瘤活性。 结果:沉默型(S)M5CAR T细胞保留了与敲除型细胞相当、某些情况下更强的抗肿瘤功能。体内实验中,S M5CAR T细胞控制肿瘤的同时持久性更高,预防转移的效果更优。体外实验显示,其对同种异体反应性NK细胞和外周血单个核细胞(PBMC)的抵抗力增强。 结论:通过靶向miRNA实现可滴定的多重基因沉默,可作为CAR-T细胞基因编辑的替代方案,在效力、持久性、转移预防和异基因产品免疫逃逸方面可能具有优势。该策略有望克服肿瘤诱导的免疫抑制,同时避免DNA双链断裂相关风险。
BACKGROUND: Multiplex gene-edited chimeric antigen receptor (CAR) T-cell therapies face significant challenges, including potential oncogenic risks associated with double-strand DNA breaks. Targeted microRNAs (miRNAs) may provide a safer, functional, and tunable alternative for gene silencing without the need for DNA editing. METHODS: As a proof of concept for multiplex gene silencing, we employed an optimized miRNA backbone and gene architecture to silence T-cell receptor (TCR) and major histocompatibility complex class I (MHC-I) in mesothelin-directed CAR (M5CAR) T cells. The efficacy of this approach was compared to CD3 and 2-microglobulin ( 2M) CRISPR/Cas9 knockout (KO) cells. miRNA-expressing cassettes were incorporated into M5CAR lentiviral vectors, enabling combined gene silencing and CAR expression. Antitumor activity was evaluated using in vitro assays and in vivo pancreatic ductal adenocarcinoma models. RESULTS: Silenced (S) M5CAR T cells retained antitumor functionality comparable to, and in some cases exceeding, that of KO cells. In vivo , S M5CAR T cells achieved tumor control with higher persistence and superior metastasis prevention. In vitro assays demonstrated enhanced resistance to alloreactive natural killer (NK) cells and peripheral blood mononuclear cells (PBMCs). CONCLUSIONS: Titratable multiplex gene silencing via targeted miRNAs offers an alternative to gene editing for CAR T cells, with potential advantages in potency, persistence, metastasis prevention, and immune evasion for allogeneic products. This strategy may overcome tumor-induced immunosuppression while avoiding the risks associated with DNA double-strand breaks.
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