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:Disulfide-Directed Multicyclic Peptides for Chimeric Antigen Receptors Targeting Solid Tumors.
这些发现共同确立了基于 DDMP 的 CAR 作为一种有前景的框架,用于工程化改造更安全而有效的实体瘤 CAR T 疗法。
嵌合抗原受体(CAR)T细胞疗法用于实体瘤的临床应用仍受显著安全性问题限制,尤其是“靶向肿瘤同时损伤正常组织”毒性和细胞因子释放综合征(CRS)。本研究介绍一类采用二硫键定向多环肽(DDMP)作为紧凑抗原识别结构域的新型CAR,靶向肿瘤相关抗原HER2和TROP2。DDMP CAR-T细胞在体内外均呈抗原密度依赖性细胞毒作用,可高效清除抗原高表达细胞,同时保留抗原低表达细胞,从而减轻靶向肿瘤同时损伤正常组织毒性。此外,DDMP CAR-T细胞在靶向杀伤后分泌的促炎细胞因子显著较少,降低了CRS风险。机制分析显示,这种细胞因子释放受控且杀伤受抗原密度门控的有利特征,与不同的T细胞信号通路激活及相较传统单链可变片段(scFv)CAR-T细胞较低的细胞亲合力相关。综上,DDMP CAR为工程化设计更安全且有效的实体瘤CAR-T疗法提供了有前景的框架。
The clinical application of chimeric antigen receptor (CAR) T cell therapy in solid tumors remains limited due to significant safety concerns, particularly "on-target, off-tumor" toxicity and cytokine release syndrome (CRS). Here, we describe a class of CARs that employ disulfide-directed multicyclic peptides (DDMPs) as compact antigen-recognition domains targeting the tumor-associated antigens HER2 and TROP2. DDMP-based CAR T cells exhibited antigen density-dependent cytotoxicity in vitro and in vivo, efficiently eliminating cells with high antigen expression while sparing cells with low antigen levels, thereby mitigating on-target, off-tumor toxicity. In addition, DDMP-based CAR T cells secreted markedly lower levels of pro-inflammatory cytokines upon targeted killing, reducing CRS risk. Mechanistic analyses revealed that this favorable combination of restrained cytokine release and density-gated killing is associated with distinct T cell signaling pathway engagement and reduced cell avidity relative to conventional single-chain variable fragment (scFv)-based CAR T cells. Collectively, these findings establish DDMP-based CARs as a promising framework for engineering safer, yet efficacious, CAR T therapies for solid tumors.
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