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:In vivo site-specific engineering to reprogram T cells.
工程化T细胞,经重编程以表达嵌合抗原受体(CAR)或T细胞受体(TCR),已改变了癌症治疗,并正在被探索作为自身免疫性疾病和感染性疾病的治疗方法。
工程化T细胞,经重编程以表达CAR或TCR,已改变了癌症治疗格局,并正被探索用于自身免疫性疾病和感染性疾病。通过基因组编辑增强T细胞功能,无论是通过破坏内源基因还是精确插入DNA载荷,均已展现出相当大的前景1。然而,体外制造过程冗长且昂贵,限制了这些疗法的可及性。体内生成CAR-T细胞可能克服这些障碍,但当前方法要么依赖持久性有限的瞬时表达,要么依赖缺乏特异性的DNA载荷随机整合。在此,我们证明,通过体内位点特异性整合大DNA载荷,可实现稳定且细胞特异性的转基因表达。我们开发了一种双载体系统,分别利用包膜递送载体和腺相关病毒递送CRISPR-Cas9核糖核蛋白和DNA供体模板。我们针对T细胞特异性递送和基因靶向效率对两种载体进行了优化。通过将CAR转基因整合到T细胞特异性基因座,我们在B细胞发育不全、血液系统恶性肿瘤和实体恶性肿瘤的人源化小鼠模型中,于体内生成了治疗水平的CAR-T细胞。这些发现为更高效、更精确且更广泛可及的T细胞疗法提供了一条路径。
Engineered T cells, reprogrammed to express chimeric antigen receptors (CAR) or T cell receptors (TCR), have transformed cancer treatment and are being explored as therapeutics for autoimmune and infectious diseases. Enhancing T cell function through genome editing, either by disrupting endogenous genes or precisely inserting DNA payloads, has shown considerable promise 1 . However, the ex vivo manufacturing process is lengthy and costly, limiting accessibility of these therapies. In vivo generation of CAR T cells could overcome these barriers, but current methods rely either on transient expression with limited durability, or on random integration of DNA payloads that lack specificity. Here we demonstrate that stable and cell-specific transgene expression can be achieved through in vivo site-specific integration of large DNA payloads. We developed a two-vector system to deliver CRISPR-Cas9 ribonucleoproteins and a DNA donor template, using enveloped delivery vehicles and adeno-associated viruses, respectively. We optimized both vectors for T cell-specific delivery and gene-targeting efficiency. By integrating a CAR transgene into a T cell-specific locus, we generate therapeutic levels of CAR T cells in vivo in humanized mouse models of B cell aplasia, and haematological and solid malignancies. These findings offer a pathway to more efficient, precise and widely accessible T cell therapies.
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