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:Chimeric antigen receptor modified hematopoietic stem cells (CAR-HSCs) arm all immune forces for anti-tumor in mice.
然而,超过 50% 的患者在接受 CAR-T 治疗后复发。
CAR-T 细胞是复发或难治性大B细胞淋巴瘤(r/r LBCL)的主要挽救疗法,但超过50%的患者在CAR-T治疗后仍会复发。本研究使用慢病毒载体将CAR基因导入造血干细胞(HSC),并在致死性照射后将CAR修饰的HSC(CAR-HSC)移植至小鼠。CAR基因转导未损害HSC的扩增、自我更新或重建能力。外周血T细胞、NK 细胞、B细胞、单核细胞和中性粒细胞均表达CAR。CAR-HSC移植可显著降低CD19阳性肿瘤负荷并延长临床前肿瘤模型小鼠的生存,且未引起严重毒性。CAR-HSC还可分化为多种表达CAR的免疫细胞,重塑肿瘤微环境,增加抗肿瘤细胞(如CD8+ T细胞)的比例并增强抗肿瘤应答,同时减少免疫抑制性细胞,例如肿瘤相关巨噬细胞2型亚群。本研究为CAR-HSC治疗r/r LBCL提供了临床前概念验证,提示该方法具有临床转化潜力。
Chimeric antigen receptor T cell (CAR-T) is the main salvage therapy for relapsed or refractory large B-cell lymphoma (r/r LBCL). However, over 50% of patients relapse after CAR-T therapy. In this work, we transduced the CAR gene into hematopoietic stem cells (HSCs) using a lentiviral vector. Chimeric antigen receptor-modified HSC (CAR-HSCs) were transplanted into mice after lethal irradiation. CAR gene transduction did not compromise the ability of HSCs to expand, self-renew, or reconstitute. CAR was expressed on T cells, natural killer cells, B cells, monocytes, and neutrophils in the peripheral blood. CAR-HSCs transplantation significantly reduced CD19 + tumor burden and prolonged the survival of mice with preclinical tumor without severe toxicity. CAR-HSCs also differentiated into different CAR-expressing immune cells that reshaped the tumor microenvironment by increasing the proportion of antitumor cells (like CD8 + T cells) and the antitumor response, and by decreasing immunosuppressive cells, such as tumor-associated macrophage subtype 2. This study demonstrated a preclinical proof-of-principle for CAR-HSCs therapy in r/r LBCL, suggesting an opportunity for its clinical translation.
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