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:Soluble-Antigen-Based PET/MR for the Specific Detection of BCMA CAR+ T-Cell Lymphoma.
利用高亲和力抗原-抗体相互作用,重组 BCMA 探针以高纯度(>98%)制备,并显示出对 BCMA CAR scFv 的纳摩尔级亲和力(K D = 5.17 nM)。
嵌合抗原受体(CAR)T细胞疗法存在罕见但严重的继发性CAR阳性T细胞淋巴瘤(CAR-TCL)风险,凸显了开发精准诊断工具的迫切需求。现有无创成像方法难以区分CAR-TCL与炎症后遗症,而活检又面临多项临床挑战。本研究重新利用B细胞成熟抗原(BCMA)的胞外结构域(BCMA-ECD)作为特异性分子识别元件,识别BCMA-CAR单链可变片段(scFv),据此开发了新型正电子发射断层成像(PET)探针[68Ga]Ga-BCMA-NOTA。利用高亲和力抗原-抗体相互作用制备重组BCMA探针,其纯度超过98%,对BCMA CAR scFv的亲和力达到纳摩尔水平(KD=5.17 nM)。探针放射化学纯度超过95%,放射化学产率超过50%。在临床前异种移植模型中,[68Ga]Ga-BCMA-NOTA PET/MR成像显示,BCMA CAR阳性肿瘤摄取高且具有特异性(2.56±0.61%ID/g),而BCMA CAR阴性肿瘤摄取可忽略不计(0.21±0.05%ID/g);肿瘤/肌肉(T/M)比为16.0±3.8。阻断实验证实该探针在体内具有靶点特异性。重要的是,在直接头对头比较中,与[18F]FDG相比,[68Ga]Ga-BCMA-NOTA的成像对比度显著更优,且与肿瘤负荷的相关性更强(R²=0.93对0.76)。这一BCMA CAR scFv特异性探针为精准无创显示BCMA CAR阳性恶性肿瘤提供了有力工具,在保障CAR-T治疗长期安全和监测方面具有重要临床转化潜力。
Chimeric antigen receptor (CAR) T-cell therapy carries a rare but critical risk of secondary CAR+ T-Cell Lymphoma (CAR-TCL), highlighting the urgent need for precise diagnostic tools. Current noninvasive imaging methods struggle to differentiate CAR-TCL from inflammatory sequelae, while biopsy presents several clinical challenges. In this study, we developed a novel positron emission tomography (PET) imaging probe, [ 68 Ga]Ga-BCMA-NOTA, by repurposing the extracellular domain of B-cell maturation antigen (BCMA-ECD) as a specific molecular recognizer for the BCMA-CAR single-chain variable fragment (scFv). Leveraging the high-affinity antigen-antibody interaction, the recombinant BCMA probe was produced with high purity (>98%) and demonstrated nanomolar affinity for the BCMA CAR scFv ( K D = 5.17 nM). The probe was synthesized with excellent radiochemical purity (>95%) and a good radiochemical yield (>50%). In preclinical xenograft models, [ 68 Ga]Ga-BCMA-NOTA PET/MR imaging demonstrated high and specific uptake in BCMA CAR-positive tumors (2.56 0.61%ID/g), compared to negligible uptake in BCMA CAR-negative tumors (0.21 0.05%ID/g), with a tumor-to-muscle (T/M) ratio of 16.0 3.8. The uptake was blockable, confirming the probe's target specificity in vivo. Importantly, in a head-to-head comparison, [ 68 Ga]Ga-BCMA-NOTA provided significantly superior imaging contrast and a stronger correlation with tumor burden ( R 2 = 0.93) compared to [ 18 F]FDG ( R 2 = 0.76). This BCMA CAR scFv-specific probe offers a powerful new tool for the precise noninvasive visualization of BCMA CAR-positive malignancies, with significant clinical translational potential for ensuring the long-term safety and monitoring of CAR-T therapies.
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