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:Inhibition of glycosphingolipid synthesis overcomes the steric hindrance of CD30 N-glycans to augment CD30-targeted immunotherapeutic efficacy.
Inhibition of glycosphingolipid synthesis overcomes the steric hindrance of CD30 N-glycans to augment CD30-targeted immunotherapeutic efficacy.
CD30靶向嵌合抗原受体(CAR)T细胞疗法在经典霍奇金淋巴瘤(cHL)中面临临床挑战。
CD30靶向嵌合抗原受体(CAR)T细胞疗法在经典霍奇金淋巴瘤(cHL)中面临临床挑战。尽管当前的优化策略聚焦于CAR设计、生产方案和预处理方案,但肿瘤内在耐药机制仍知之甚少。我们的研究揭示,cHL细胞中的CD30与Asn101和Asn276位点的N-聚糖相关,这些N-聚糖对蛋白质稳定性至关重要,但不影响细胞增殖或凋亡。基因敲除这些N-聚糖或酶促去糖基化显著增强了CD30靶向CAR-T细胞对肿瘤细胞的可及性,从而导致T细胞活化和细胞毒功能改善。值得注意的是,依利格鲁司他(eliglustat,一种FDA批准的糖鞘脂合成抑制剂)预处理选择性增强了CD30靶向CAR-T细胞在表达野生型CD30肿瘤中的抗肿瘤活性,但对CD30糖基化缺陷变体的影响极小。依利格鲁司他联合CD30靶向CAR-T细胞在异种移植模型中实现了更优的肿瘤控制,且未增加毒性。在机制上,依利格鲁司他修剪了CD30 N-聚糖的末端唾液酸,同时保留了核心N-聚糖结构。此外,加入依利格鲁司他还在体外和体内增强了brentuximab vedotin(BV,一种CD30导向的抗体-药物偶联物)的肿瘤杀伤活性。这种糖免疫治疗范式代表了一种临床上可操作的方法,用于克服聚糖介导的免疫逃逸并增强CD30阳性淋巴瘤的治疗疗效。
CD30-targeted chimeric antigen receptor (CAR) T-cell therapy faces clinical challenges in classical Hodgkin lymphoma (cHL). While current optimization strategies focus on CAR design, manufacturing protocols, and preconditioning regimens, tumor-intrinsic resistance mechanisms remain poorly understood. Our study revealed that CD30 in cHL cells is associated with N-glycans at Asn101 and Asn276, which are essential for protein stability but do not affect cell proliferation or apoptosis. Genetic ablation of these N-glycans or enzymatic deglycosylation significantly enhanced CD30-targeted CAR-T-cell accessibility to tumor cells, leading to improved T-cell activation and cytotoxic function. Notably, pretreatment with eliglustat, an FDA-approved glycosphingolipid synthesis inhibitor, selectively potentiated the antitumor activity of CD30-targeted CAR-T cells in wild-type CD30-expressing tumors but had minimal effects on CD30 glycosylation-deficient variants. Eliglustat combined with CD30-targeted CAR-T cells resulted in superior tumor control in xenograft models without additional toxicity. Mechanistically, eliglustat trimmed terminal sialic acids from CD30 N-glycans while preserving the core N-glycan structure. Furthermore, the addition of eliglustat also enhanced the tumor-killing activity of brentuximab vedotin (BV), a CD30-directed antibody-drug conjugate, both in vitro and in vivo. This glycoimmunotherapy paradigm represents a clinically actionable approach to overcome glycan-mediated immune evasion and enhance therapeutic efficacy in CD30-positive lymphomas.
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