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:Signaling intact membrane-bound IL-15 enables potent anti-tumor activity and safety of CAR-NK cells.
头对头比较研究显示,与 sIL-15 相比,信号完整的 mbIL-15 显著提高了 CAR-NK 细胞的疗效和安全性,为未来临床开发提供了临床前证据。
背景:嵌合抗原受体(CAR)NK细胞是CAR-T细胞的一种有前景且安全的替代方案,但其体内持续时间有限,制约了临床应用和持久治疗应答。白细胞介素-15(IL-15)已广泛用于改善CAR-NK细胞的持续存在和效能。然而,IL-15蓄积可能导致CAR-NK细胞不受控制地增殖,进而引发致命不良反应。因此,亟须开发安全有效的替代策略,以增强CAR-NK细胞的持续性和抗肿瘤活性。方法:研究者通过将IL-15与全长IL-15受体(IL-15R)融合,设计了信号功能完整的膜结合型IL-15(mbIL-15),并在靶向B7H3的CAR-NK细胞系统中,通过多种体外和体内实验,系统比较其与分泌型IL-15(sIL-15)的功能和安全性。结果:表达sIL-15或mbIL-15均可通过激活STAT5显著促进增殖,并提高CAR-NK细胞在体内外的抗肿瘤活性。尽管表达sIL-15的CAR-NK细胞可迅速清除腹腔卵巢癌,但小鼠出现严重后果,包括CAR-NK细胞扩增失调、强烈炎症反应及不可逆器官损伤。相比之下,携带mbIL-15的CAR-NK细胞增殖适度、杀瘤活性强,在局部治疗和全身给药模型中均未观察到明显不良反应。结论:头对头比较研究显示,与sIL-15相比,信号功能完整的mbIL-15可显著提高CAR-NK细胞治疗的疗效和安全性,为其后续临床开发提供了临床前证据。
BACKGROUND: Chimeric antigen receptor (CAR)-NK cells are a promising and safe alternative to CAR-T cells. However, the limited persistence in vivo restricts their clinical application and sustained therapeutic responses. IL-15 has been extensively used to improve CAR-NK cell persistence and effectiveness. Nevertheless, accumulation of IL-15 might induce uncontrolled proliferation of CAR-NK cells and thus lead to fatal side-effects. Therefore, it is essential to develop a safe and effective alternative strategy to improve the persistence and anti-tumor activity of CAR-NK cells. METHODS: A signaling intact membrane-bound IL-15 (mbIL-15) was designed by fusing IL-15 and full-length IL-15R and was systematically compared with secretory IL-15 (sIL-15) in a B7H3-targeting CAR-NK cell system regarding their functionality and safety through various in vitro and in vivo experiments. RESULTS: Both expression of sIL-15 or mbIL-15 significantly enhanced the proliferation by activating STAT5 and improved anti-tumor activity of CAR-NK cells in vitro and in vivo . Although CAR-NK cells with sIL-15 quickly eliminated intraperitoneal ovarian cancer, the mice experienced severe consequences, including dysregulated CAR-NK cell expansion, intense inflammatory responses, and irreversible organ damages. In contrast, CAR-NK cells carrying mbIL-15 showed moderate cell proliferation and potent tumor killing activity without observable adverse effects in both local treatment and systemic administration models. CONCLUSION: Head-to-head comparative studies demonstrated that signaling intact mbIL-15 significantly improved therapeutic efficacy and safety of CAR-NK cells compared to sIL-15, which provided preclinical evidence for future clinical development.
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