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:Sodium valproate drives propionylation-mediated epigenetic reprogramming to enhance mesothelin CAR-T cell therapy in solid tumors.
这些发现支持代谢-表观遗传调控作为改善实体瘤中 CAR-T 疗法的一种策略。
CAR-T细胞疗法已在血液系统恶性肿瘤中显示出成功,但在实体瘤中仍受限于持续性差、迁移能力差以及肿瘤微环境诱导的耗竭。在一项研究者发起的复发/难治性卵巢癌试验中,靶向间皮素的CAR-T细胞显示出75%的部分缓解率和良好的安全性。为提高疗效,我们将CAR-T疗法与丙戊酸钠(VPA)联合,VPA是一种临床批准的组蛋白去乙酰化酶抑制剂。经VPA处理的CAR-T细胞(CAR-T+VPA)表现出细胞毒性增强、耗竭减少和肿瘤浸润增强。机制上,VPA诱导组蛋白丙酰化,尤其是H3K56pr,从而导致关键基因的转录激活。LOX促进迁移和黏附,而GUCY1B3增强代谢适应性。CUT&Tag和RNA测序分析证实了VPA驱动的与T细胞持续性和效应功能相关通路的表观遗传重塑。CAR-T+VPA细胞表现出氧化磷酸化和糖酵解升高,支持在不利肿瘤环境中的持续活性。在卵巢癌和三阴性乳腺癌异种移植模型中,VPA显著改善了肿瘤控制和生存,且未增加毒性。这些发现支持代谢-表观遗传调控作为改善实体瘤中CAR-T疗法的策略。
Chimeric antigen receptor (CAR)-T cell therapy has shown success in hematologic malignancies but remains limited in solid tumors due to poor persistence, migration, and tumor microenvironment-induced exhaustion. In an investigator-initiated trial in relapsed/refractory ovarian cancer, mesothelin-targeted CAR-T cells demonstrated a 75% partial response rate and good safety. To enhance efficacy, we combined CAR-T therapy with sodium valproate (VPA), a clinically approved histone deacetylase inhibitor. VPA-treated CAR-T cells (CAR-T+VPA) showed improved cytotoxicity, reduced exhaustion, and enhanced tumor infiltration. Mechanistically, VPA induced histone propionylation, particularly H3K56pr, leading to transcriptional activation of key genes. LOX promoted migration and adhesion, while GUCY1B3 enhanced metabolic fitness. CUT&Tag and RNA sequencing analyses confirmed VPA-driven epigenetic remodeling of pathways linked to T cell persistence and effector function. CAR-T+VPA cells exhibited elevated oxidative phosphorylation and glycolysis, supporting sustained activity in hostile tumor environments. In xenograft models of ovarian and triple-negative breast cancer, VPA significantly improved tumor control and survival without added toxicity. These findings support metabolic-epigenetic modulation as a strategy to improve CAR-T therapy in solid tumors.
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