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:Evaluation of dasatinib and ponatinib for the control of CD123 CAR-T cell functionalities.
CD123 CAR-T 细胞(CAR123)是治疗母细胞性浆细胞样树突状细胞肿瘤(BPDCN)和 CD123 + 急性髓系白血病(AML)的一种有前景的治疗手段。
靶向CD123的CAR-T细胞(CAR123)是治疗母细胞性浆细胞样树突细胞肿瘤(BPDCN)和CD123阳性急性髓系白血病(AML)的有前景策略。然而,CAR-T细胞活化引起的促炎环境可诱导内皮细胞上调CD123,带来潜在的靶向肿瘤同时损伤正常组织毒性。本研究评估两种酪氨酸激酶抑制剂(TKI)——达沙替尼和泊那替尼——可逆抑制CAR-T细胞功能的能力。研究采用CAR123与BPDCN和AML细胞系共培养的多种体外模型,发现两种TKI均可降低CAR123活化表型(CD69、CD25)、肿瘤坏死因子(TNF)和干扰素(IFN)分泌、脱颗粒(CD107a)及对白血病细胞的杀伤;移除TKI后,这种抑制可逆。但只有达沙替尼在临床相关浓度下有效:50 nM即可抑制TNF和IFN分泌,对白血病细胞的细胞毒作用仅轻微下降,同时可通过抑制细胞因子分泌,有效控制CAR-T细胞对内皮细胞的细胞毒性。因此,达沙替尼可能在不损害抗白血病作用的前提下,降低CAR123对内皮细胞的潜在毒性;发生毒性时,也可使用更高剂量完全抑制CAR-T功能。
CD123 CAR-T cells (CAR123) represent a promising therapeutic approach for blastic plasmacytoid dendritic cell neoplasm (BPDCN) and CD123 + acute myeloid leukemia (AML). However, the pro-inflammatory environment resulting from CAR-T cell activation can induce CD123 upregulation on endothelial cells and potential on-target/off-tumor toxicity. We evaluated the capacity of two tyrosine kinase inhibitors (TKIs), dasatinib and ponatinib, to reversibly inhibit CAR-T cell functions. Using different in vitro models of CAR123 co-culture with BPDCN and AML cell lines, we show that both TKIs reduce CAR123 activation phenotype (CD69 and CD25), tumor necrosis factor (TNF- ) and interferon- (IFN- ) secretion; degranulation (CD107a); and killing of leukemia cells. Moreover, this inhibition was reversible after elimination of the TKIs. However, only dasatinib was effective at clinically relevant concentrations; 50 nM inhibited TNF- and IFN- secretion, with only a slight reduction in cytotoxicity toward leukemia cells and allowed effective control of CAR-T cell cytotoxicity against endothelial cells in relation to the inhibition of cytokine secretion. Thus, dasatinib could be used to minimize potential CAR123 toxicity toward endothelial cells without compromising its anti-leukemic effects. However, a higher dose could be used to completely inhibit CAR-T cell functionality in the event of toxicity.
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