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:Augmenting CAR T cell functionality and metabolism through CD39 downtuning.
CD39/CD73轴是T细胞功能的有效内在抑制因子。
CD39/CD73轴是T细胞功能强大的内在抑制因子。CAR T细胞激活触发CD39升高;与常规CAR T细胞相比,CD39低表达CAR T细胞中CD39的下调减少了细胞外ATP降解,并增强了功能能力,表现为在重复CAR刺激下颗粒酶/穿孔素增加和脱颗粒增强。此外,CD39低表达CAR T细胞表现出更优的线粒体功能和增强的糖酵解活性。因此,在异种移植NSG小鼠中,CD39低表达CAR T细胞在控制CEA+胃癌方面优于常规CAR T细胞。CD39效应是独特的,因为同样参与耗竭调节的CD38下调在刺激性“应激条件”下并未提供益处。激活诱导的CD39/CD73上调促成了CAR T细胞的负反馈环路;CD39水平下调通过减少AMP和腺苷介导的抑制,增强了T细胞抗肿瘤活性。在更广泛的背景下,CD39下调不太可能作为单一干预在所有情况下都足够,但作为联合策略的一部分,与靶向其他代谢或免疫检查点通路的互补方法结合,以进一步增强CAR T细胞持久性和抗肿瘤活性,可能特别有价值。
The CD39/CD73 axis is a potent intrinsic repressor of T cell functionality. CAR T cell activation triggers the increase of CD39; its downregulation reduced extracellular ATP degradation and enhanced the functional capacities in CD39 low CAR T cells compared with conventional CAR T cells with respect to an increase in granzyme/perforin and degranulation upon repetitive CAR stimulation. CD39 low CAR T cells, moreover, displayed superior mitochondrial function and enhanced glycolytic activities. Consequently, CD39 low CAR T cells outperformed conventional CAR T cells in controlling CEA + gastric carcinoma in xeno-transplanted NSG mice. The CD39 effect is unique, since downtuning CD38, also involved in the regulation of exhaustion, did not provide benefits under stimulatory "stress conditions". Activation-induced upregulation of CD39/CD73 contributes to a negative feedback loop for CAR T cells; downregulated CD39 levels augmented T cell anti-tumor activities by reducing AMP and adenosine-mediated repression. In the broader context, CD39 downregulation is unlikely to be sufficient as a standalone intervention in all settings but may be particularly valuable as part of combination strategies with complementary approaches targeting additional metabolic or immune checkpoint pathways to further enhance CAR T cell persistence and anti-tumor activity.
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