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:A CDK4/6 inhibitor-armed oncolytic adenovirus reverses T cell exhaustion through the Rb-p65-CCL5 pathway and potentiates the antitumor activity of anti-PD-1 or CAR-T therapy in colorectal cancer.
这些发现提示,通过改造溶瘤病毒以局部调控参与 T 细胞耗竭的通路,是增强抗肿瘤免疫的一种可行且可转化的策略。
引言:溶瘤腺病毒治疗结直肠癌模型的疗效受到一种治疗诱导限制:为持续溶瘤而需要高剂量、重复给药,这会导致慢性抗原暴露和肿瘤微环境应激,使CD8+ T细胞进入耗竭状态。 方法:为减轻这一问题,我们构建了溶瘤腺病毒ADV-PTD4-D3,使其能够在肿瘤内表达CDK4/6肽抑制剂。这种局部策略旨在保留免疫调节潜力,同时尽量减少全身暴露。在同系小鼠模型中,ADV-PTD4-D3改善了肿瘤控制,并能诱导强效、抗原特异性免疫记忆;其治疗作用主要依赖CD8+ T细胞。值得注意的是,该病毒在人源化异种移植模型中也表现出强效抗肿瘤活性,且免疫健全宿主中未见明显脱靶毒性。 结果:其作用机制涉及如下信号轴:病毒介导的CDK4/6抑制降低视网膜母细胞瘤(Rb)蛋白磷酸化,减轻Rb对NF-κB p65亚基的隔离,使p65能够转位入核并转录上调T细胞趋化因子CCL5;CCL5与患者预后较好相关。因此,ADV-PTD4-D3通过提供持续的CCL5趋化信号,促进CD8+ T细胞募集,形成T细胞炎症型微环境。此外,该治疗策略成功逆转了浸润CD8+ T细胞的功能耗竭,解决了有效治疗的两大障碍:浸润不足和功能耗竭。通过这种方式改造肿瘤微环境后,携带治疗载荷的病毒可同时改善PD-1阻断和CAR-T细胞疗法的抗肿瘤应答。 讨论:这些发现提示,对溶瘤病毒进行工程化改造、使其在局部调节与T细胞耗竭有关的通路,是增强抗肿瘤免疫的一种可行且可转化策略。
INTRODUCTION: The efficacy of oncolytic adenoviruses in colorectal cancer models is constrained by a treatment-induced limitation: the high-dose, repetitive administration required for sustained oncolysis promotes chronic antigen exposure and tumor microenvironmental stress, driving CD8+ T cells into a state of exhaustion. METHODS: To mitigate this, we constructed an oncolytic adenovirus, ADV-PTD4-D3, engineered for intratumoral expression of a peptide inhibitor of CDK4/6. This local strategy aims to retain immunomodulatory potential while minimizing systemic exposure. In syngeneic murine models, ADV-PTD4-D3 demonstrated improved tumor control and the ability to induce robust, antigen-specific immunological memory, with its therapeutic effect being primarily dependent on CD8+ T cells. Notably, it also exhibited potent antitumor activity in a humanized xenograft model and showed no evidence of significant off-target toxicity in immunocompetent hosts. RESULTS: The mechanism involves a signaling axis where viral-mediated CDK4/6 inhibition reduces retinoblastoma (Rb) protein phosphorylation. This decrease relieves Rb-mediated sequestration of the NF-kB p65 subunit, allowing p65 nuclear translocation and transcriptional upregulation of the T-cell chemoattractant CCL5, a factor linked to favorable patient prognosis. Thus, ADV-PTD4-D3 promotes a T-cell-inflamed microenvironment by providing a sustained chemotactic signal CCL5 for CD8+ T cell recruitment. Furthermore, this treatment strategy successfully reverses the functional exhaustion of infiltrating CD8+ T cells, thereby addressing two major barriers to effective therapy: inadequate infiltration and functional exhaustion. By modifying the tumor microenvironment in this way, the armed virus addresses two factors that limit T-cell-based immunotherapies: inadequate infiltration and functional exhaustion. Correspondingly, ADV-PTD4-D3 treatment improved the antitumor response to both PD-1 blockade and CAR-T cell therapy in combination studies. DISCUSSION: These findings suggest that engineering oncolytic viruses to locally modulate pathways involved in T cell exhaustion represents a viable and translatable strategy for enhancing antitumor immunity.
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