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 generation of CAR myeloid cells through erythrocyte-mediated mRNA delivery for cancer immunotherapy.
我们的研究建立了一个可临床转化的基于红细胞的 mRNA 平台,该平台能够实现直接的体内免疫细胞编程,并推动了针对实体瘤的 CAR 髓系疗法的发展。
利用嵌合抗原受体(CAR)工程化髓系细胞具有巨大的治疗前景,但其在体内生成仍面临挑战。在此,我们开发了一种红细胞介导的信使RNA(mRNA)递送平台,称为mRNA-LNP-Ery,其中负载mRNA的脂质纳米颗粒(LNP)被共价锚定在红细胞上。利用红细胞固有的脾脏归巢能力和独特的生物相容性,mRNA-LNP-Ery能够高度选择性和高效地将mRNA递送至脾脏中的CD11b+髓系细胞,而肝细胞的摄取极少。我们还证明mRNA-LNP-Ery通过吞噬作用被内化并避免溶酶体降解,从而增强胞质mRNA翻译。递送编码靶向人表皮生长因子受体2(HER2)或CD19的CAR的mRNA,在体内生成了功能性CAR髓系细胞,其呈现促炎、抗原呈递表型。这些细胞迁移至肿瘤,消除癌细胞并重塑肿瘤微环境,导致效应T细胞和自然杀伤(NK)细胞浸润增加。抗肿瘤效应在脾切除小鼠中被消除,在裸鼠中部分减弱,表明治疗活性依赖于脾脏内CAR髓系细胞的形成及其与适应性免疫的交互作用。此外,重复给予mRNA-LNP-Ery在仅为常规mRNA-LNP十分之一mRNA剂量时即实现了更优的抗肿瘤疗效,且全身毒性极小,凸显了脾脏靶向递送的高效性和安全性。总之,我们的研究建立了一个临床可转化的基于红细胞的mRNA平台,能够直接在体内编程免疫细胞,并推进针对实体瘤的CAR髓系疗法。
Engineering myeloid cells with chimeric antigen receptors (CARs) holds great therapeutic promise, but their generation in vivo remains challenging. Here, we developed an erythrocyte-mediated messenger RNA (mRNA) delivery platform, termed mRNA-LNP-Ery, in which mRNA-loaded lipid nanoparticles (LNPs) are covalently anchored onto erythrocytes. Exploiting erythrocytes' intrinsic splenic homing capacity and unique biocompatibility, mRNA-LNP-Ery enables highly selective and efficient mRNA delivery to CD11b + myeloid cells in the spleen, with minimal uptake by hepatocytes. We also demonstrated that mRNA-LNP-Ery is internalized through phagocytosis and avoids lysosomal degradation, resulting in enhanced cytosolic mRNA translation. Delivery of mRNAs encoding CARs targeting human epidermal growth factor receptor 2 (HER2) or CD19 generated functional CAR myeloid cells in vivo that adopted a proinflammatory, antigen-presenting phenotype. These cells migrated to tumors, eliminated cancer cells, and remodeled the tumor microenvironment, leading to increased infiltration of effector T and natural killer (NK) cells. The antitumor effect was abolished in splenectomized mice and partially diminished in nude mice, indicating that therapeutic activity depends on both CAR myeloid cell formation within the spleen and their cross-talk with adaptive immunity. Furthermore, repeated administration of mRNA-LNP-Ery achieved superior antitumor efficacy to conventional mRNA-LNPs at one-tenth the mRNA dose, with minimal systemic toxicity, underscoring the high efficiency and safety of spleen-targeted delivery. Together, our findings established a clinically translatable erythrocyte-based mRNA platform that enables direct in vivo immune cell programming and advances CAR myeloid therapies for solid tumors.
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