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:Clickable Universal Tumor-Antigen Equipping Strategy for Remedial Chimeric Antigen Receptor T Cells to Destroy Solid Tumors.
嵌合抗原受体(CAR)-T细胞疗法在白血病和淋巴瘤中展现出显著疗效,但实体瘤仍大多难以治疗,原因在于肿瘤特异性抗原稀缺及广泛的抗原异质性,加之CAR-T细胞快速耗竭限制了其功能与持久性。
嵌合抗原受体(CAR)-T细胞疗法在白血病和淋巴瘤中显示出显著疗效,但实体瘤在很大程度上仍难以攻克,原因在于肿瘤特异性抗原的匮乏和普遍存在的抗原异质性,再加上CAR-T细胞快速耗竭,削弱了其功能与持久性。在此,我们提出一种可点击的通用肿瘤抗原装配(CUTE)策略,通过代谢糖工程(MGE)将外源性抗原模块化地点击连接到肿瘤细胞表面,从而重塑肿瘤抗原的格局。CUTE策略在Raji细胞上产生的抗原密度比内源性CD19高5.7倍,并在体外显著提高了CAR-T细胞的功能亲和力。由此形成的高抗原密度稳定了CAR构象,阻止了scFv聚集驱动的强直信号,进而减少了CAR-T细胞的耗竭。在细胞来源和患者来源的异种移植(CDX和PDX)模型中,CUTE策略赋予CAR-T细胞对肿瘤的补救性治疗效果,显著延长了总生存期,且未观察到额外毒性。因此,CUTE策略提供了一个模块化平台,可将经临床验证的CAR-T细胞重定向至任何实体瘤,并为将CAR-T疗法拓展至血液系统恶性肿瘤之外提供了一条具有潜在转化价值的路径。
Chimeric antigen receptor (CAR)-T cell therapy has shown striking efficacy in leukemia and lymphoma, but solid tumors remain largely refractory due to the scarcity of tumor-specific antigens and pervasive antigen heterogeneity, compounded by rapid CAR-T cell exhaustion that curtails their function and persistence. Here, we propose a clickable universal tumor-antigen equipping (CUTE) strategy in which exogenous antigen is modularly clicked onto the tumor cell surface by metabolic glycoengineering (MGE), remodeling the landscape of tumor antigens. The CUTE strategy yielded a 5.7-fold higher antigen density than endogenous CD19 on Raji cells and markedly increased the functional avidity of CAR-T cells in vitro. The resulting high antigen density stabilized CAR conformations, prevented scFv aggregation-driven tonic signaling, and consequently reduced the exhaustion of CAR-T cells. In both cell-derived and patient-derived xenograft (CDX and PDX) models, the CUTE strategy conferred remedial therapeutic efficacy of CAR-T cells against tumors, significantly prolonging overall survival, with no added toxicity observed. Thus, the CUTE strategy provides a modular platform for redirecting clinically validated CAR-T cells to any solid tumor and offers a potentially translatable route to extend CAR-T therapy beyond hematological cancers.
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