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:Synergizing hypomethylating agents with off-the-shelf CD70-targeted chimeric antigen receptor-engineered natural killer T cells for the treatment of acute myeloid leukemia.
急性髓系白血病(AML)是一种侵袭性血液系统恶性肿瘤,其特征是骨髓中未分化的髓系前体细胞不受控制地扩增。
急性髓系白血病(AML)是一种侵袭性血液系统恶性肿瘤,其特征是骨髓中未分化的髓系前体细胞不受控制地扩增。去甲基化药物(HMA)如阿扎胞苷和地西他滨可以逆转异常的DNA甲基化,促进白血病细胞分化,并增强免疫识别,但复发和治疗耐药仍是主要挑战。在本研究中,我们发现长期低剂量HMA治疗上调了AML肿瘤细胞上的CD70、NK受体配体和CD1d,使其更易受嵌合抗原受体(CAR)工程化恒定自然杀伤T(CAR-NKT)细胞介导的细胞毒性作用。为了利用这些特征,我们生成了两种靶向CD70的CAR-NKT细胞:脐血造血干细胞和祖细胞(HSPC)来源的异体CAR70-NKT(Allo CAR70-NKT)细胞和外周血单个核细胞(PBMC)来源的CAR70-NKT(PBMC CAR70-NKT)细胞。两种CAR70-NKT细胞产品均对AML细胞表现出强效细胞毒性,并与HMA产生协同作用,而Allo CAR70-NKT细胞表现出更优的抗肿瘤疗效、多靶点识别和持续扩增能力。在多个异种移植模型中,Allo CAR70-NKT细胞有效杀伤AML肿瘤,且未诱导移植物抗宿主病、细胞因子释放综合征或长期器官毒性。这些发现凸显了Allo CAR70-NKT细胞作为一种安全且强效的现货型免疫疗法,可与HMA协同作用以改善AML患者的治疗结局。
Acute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by the uncontrolled expansion of undifferentiated myeloid precursors in the bone marrow. Hypomethylating agents (HMAs) such as azacitidine and decitabine can reverse abnormal DNA methylation, promote leukemic cell differentiation, and enhance immune recognition, yet relapse and therapeutic resistance remain major challenges. In this study, we found that long-term, low-dose HMA treatment upregulated CD70, NK receptor ligands, and CD1d on AML tumor cells, rendering them more susceptible to chimeric antigen receptor (CAR)-engineered invariant natural killer T (CAR-NKT) cell-mediated cytotoxicity. To exploit these features, we generated two types of CD70-targeting CAR-NKT cells: cord blood hematopoietic stem and progenitor cell (HSPC)-derived allogeneic CAR70-NKT ( Allo CAR70-NKT) cells and peripheral blood mononuclear cell (PBMC)-derived CAR70-NKT ( PBMC CAR70-NKT) cells. Both CAR70-NKT cell products exhibited potent cytotoxicity against AML cells and synergized with HMAs, while Allo CAR70-NKT cells demonstrated superior antitumor efficacy, multi-target recognition, and sustained expansion. In multiple xenograft models, Allo CAR70-NKT cells effectively killed AML tumors without inducing graft-versus-host disease, cytokine release syndrome, or long-term organ toxicity. These findings highlight Allo CAR70-NKT cells as a safe and powerful off-the-shelf immunotherapy that can synergize with HMAs to improve treatment outcomes for patients with AML.
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