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:DR5 CAR-T cells target melanoma and suppress MDSCs with minimal toxicity.
这些结果支持 DR5 靶向 CAR-T 疗法作为治疗实体瘤的一种有前景的策略,其将直接的肿瘤细胞毒性与免疫激活相结合,同时最大限度减少脱靶效应。
嵌合抗原受体(CAR)T 细胞疗法因靶点特异性有限及免疫抑制性肿瘤微环境,在实体瘤中的疗效较差。我们基于死亡受体5(DR5)在实体瘤和髓源性抑制细胞(MDSC)中均高表达,将其作为 CAR 靶点进行研究。我们构建了激动型 DR5 特异性 CAR,并在多个模型中评估其活性,结果显示肿瘤杀伤依赖 DR5 表达,敲除和过表达实验也证实了这一点。DR5 靶向单链可变片段即使表达于非效应细胞或细胞外囊泡上,仍保留促凋亡活性。在多种 CAR 设计中,我们筛选出一种结合亲和力优化的构建体,可维持 T 细胞存活,同时保留强效肿瘤和 MDSC 杀伤能力。为在免疫健全环境中评估安全性和疗效,我们还开发了小鼠 DR5 靶向 CAR。在多个异种移植和同系小鼠模型中,DR5 CAR-T 细胞降低肿瘤生长、延长生存,且未引起可检测毒性。在患者来源类器官及组织切片中,DR5 CAR-T 细胞可浸润肿瘤组织、减少 MDSC、增强 CD8⁺ T 细胞活性并抑制肿瘤生长。这些结果支持 DR5 靶向 CAR-T 作为治疗实体瘤的有前景策略:该疗法兼具直接杀伤肿瘤及激活免疫的作用,同时可减少脱靶效应。
Chimeric antigen receptor (CAR) T cell therapies have poor efficacy in solid tumors due to limited target specificity and an immunosuppressive tumor microenvironment. We investigated death receptor 5 (DR5) as a CAR target based on its high expression in both solid tumors and myeloid-derived suppressor cells (MDSCs). We engineered agonistic DR5-specific CAR constructs and evaluated their activity in multiple models, demonstrating DR5 expression-dependent tumor killing, confirmed by knockout and overexpression experiments. DR5-targeting single-chain variable fragments retained their pro-apoptotic activity when expressed on non-effector cells or extracellular vesicles. Among multiple CAR designs, we identified a construct with optimized binding affinity that maintained T cell viability while preserving strong tumor and MDSC killing potency. To assess safety and efficacy in an immunocompetent setting, we also developed a murine DR5-targeted CAR. In multiple xenograft and syngeneic mouse models, DR5 CAR-T cells reduced tumor growth, prolonged survival, and did not cause detectable toxicity. In patient-derived organoids and tissue slices, DR5 CAR-T cells infiltrated tumor tissues, reduced MDSCs, boosted CD8 + T cell activity, and inhibited tumor growth. These findings support DR5-targeted CAR-T therapy as a promising strategy for treating solid tumors, combining direct tumor cytotoxicity with immune activation while minimizing off-target effects.
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