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:KLF4 overexpression in CAR T cells enhances antitumor potency by preventing exhaustion.
我们的研究结果凸显了 KLF4 过表达作为对抗 CAR-T 细胞耗竭并增强抗肿瘤活性的治疗手段的潜力,提示其在临床免疫治疗中的治疗前景。
背景:嵌合抗原受体(CAR)T 细胞疗法是难治或复发淋巴瘤、白血病患者的一种有前景免疫疗法,但 CAR-T 活性不足和持续性有限,妨碍疗效持久。 方法:研究者制备 KLF4 过表达 CAR-T 细胞,采用体外刺激模型和 RNA 测序评估其功能、耗竭状态和转录变化,并在小鼠模型中验证抗肿瘤疗效。 结果:KLF4 过表达可增强 CAR-T 抗肿瘤疗效的持久性,提升 CAR-T 活性并促进其分化为效应 CAR-T 细胞。此外,KLF4 过表达可预防持续肿瘤抗原刺激诱导的 CAR-T 耗竭。RNA 测序证实,KLF4 过表达使 CAR-T 中效应功能相关基因上调、耗竭相关基因下调。值得注意的是,与常规 CAR-T 相比,KLF4 过表达 CAR-T 可延缓肿瘤生长、延长血液系统恶性肿瘤小鼠的生存,并在体内表现出更低耗竭和更强效应功能。 结论:研究结果凸显 KLF4 过表达作为对抗 CAR-T 耗竭、增强抗肿瘤活性的潜在治疗策略,强调其在临床免疫治疗中的前景。
BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapy for patients with refractory or relapsed lymphoma or leukemia. However, inefficient activity and insufficient persistence of CAR T cells impede the durability of its therapeutic efficacy. METHODS: Kr ppel-like factor 4 (KLF4)-overexpressing CAR T cells were generated and assessed for function, exhaustion, and transcriptional changes using in vitro stimulation models and RNA sequencing, with antitumor efficacy validated in mouse models. RESULTS: We report that KLF4 overexpression enhances the durability of CAR T-cell antitumor efficacy. KLF4 overexpression enhanced CAR T-cell activity and promoted the differentiation into effector CAR T cells. Furthermore, KLF4 overexpression prevented CAR T-cell exhaustion induced by continuous tumor antigen stimulation. RNA sequencing data confirmed that KLF4 overexpression led to the upregulation of genes involved in effector functions and the downregulation of genes associated with exhaustion in CAR T cells. Notably, KLF4-overexpressing CAR T cells delayed tumor growth, prolonged the survival of mice with hematological malignancies, and exhibited reduced exhaustion and enhanced effector functions in vivo relative to normal CAR T cells. CONCLUSIONS: Our findings highlight the potential of KLF4 overexpression as a therapeutic approach to counteract CAR T-cell exhaustion and enhance antitumor activity, underscoring its therapeutic promise in clinical immunotherapy.
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