CAR-T 细胞治疗与美国 Medicare 受益者的心血管结局
Chimeric antigen receptor T-cell therapy and cardiovascular outcomes in US Medicare beneficiaries.
在接受 CAR-T 的最大规模全国性老年人群样本中,5.8% 的患者发生 MACE,且与院内死亡率和 1 年死亡率升高相关。
英文原题:PSMA-targeted CAR-macrophages drive glycolytic reprogramming for enhanced prostate cancer immunotherapy.
尽管嵌合抗原受体(CAR)-T 细胞在血液系统恶性肿瘤中已显示出显著疗效,但其在实体瘤中的效果受限于肿瘤浸润差和严重的细胞因子释放综合征(CRS)。
尽管嵌合抗原受体(CAR)T细胞治疗血液系统恶性肿瘤疗效显著,但其治疗实体瘤的效果受到肿瘤浸润不足和严重细胞因子释放综合征(CRS)限制。CAR巨噬细胞(CAR-M)疗法利用巨噬细胞天然的肿瘤归巢能力,可实现抗原特异性吞噬和免疫活化,且不会诱发CRS,因此已成为有前景的替代方案。前列腺特异性膜抗原(PSMA)在前列腺癌细胞中高表达,是理想治疗靶点。本研究构建了PSMA特异性CAR-M,其在体内外均对前列腺癌细胞具有强效抗肿瘤活性。识别PSMA后,PSMA特异性CAR-M表现出强烈的抗原依赖性吞噬能力,并向促炎、杀瘤表型极化。从机制上看,与表达PSMA的前列腺癌细胞相互作用可诱导代谢重编程,表现为糖酵解增强、氧化磷酸化受抑,从而强化CAR-M的抗肿瘤功能。本研究提示,靶向PSMA的CAR-M疗法是治疗前列腺癌的一种有前景的免疫治疗方法。
Although chimeric antigen receptor (CAR)-T cells have demonstrated remarkable efficacy against hematologic malignancies, their effectiveness in solid tumors is limited by poor tumor infiltration and severe cytokine release syndrome (CRS). CAR-macrophage (CAR-M) therapy has emerged as a promising alternative, leveraging the innate tumor-homing capacity of macrophages while enabling antigen-specific phagocytosis and immune activation without triggering CRS. Prostate-specific membrane antigen (PSMA) represents an ideal therapeutic target due to its high expression in prostate cancer cells. In this study, we engineered PSMA-specific CAR-M with potent anti-tumor activity against prostate cancer cells both in vitro and in vivo. PSMA-specific CAR-M exhibited strong antigen-dependent phagocytic capability and underwent polarization toward a pro-inflammatory, tumoricidal phenotype upon PSMA recognition. Mechanistically, interaction with PSMA-expressing prostate cancer cells induced metabolic reprogramming, characterized by enhanced glycolytic activity and suppressed oxidative phosphorylation, which reinforced the anti-tumor function of CAR-M. Our findings highlight PSMA-targeted CAR-M therapy as a promising immunotherapeutic approach for prostate cancer.
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