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:Irradiated CD19 chimeric antigen receptor YTS cells retain antitumor activity and offer a scalable alternative to autologous CAR-T therapy.
嵌合抗原受体(CAR)T 细胞疗法彻底改变了淋巴瘤和多发性骨髓瘤等血液系统恶性肿瘤的治疗。
嵌合抗原受体(CAR)T 细胞疗法革新了淋巴瘤和多发性骨髓瘤等血液系统恶性肿瘤的治疗,但其应用仍受制造成本高、依赖自体 T 细胞、产品质量不稳定,以及细胞因子释放综合征等危及生命的毒性限制。自然杀伤(NK)细胞相较之下更安全、灵活,但复杂的扩增流程和高生产成本仍阻碍其临床转化。本研究提出一种新方法,使用适合大规模培养、基因操作和冷冻保存的人 NK 细胞系 YTS。通过在 YTS 细胞中导入 CD19 特异性 CAR,我们获得了可选择性清除 CD19 表达靶细胞的强效效应细胞。研究显示,YTS 细胞中的 CAR 信号需要细胞内活化;在特定肿瘤环境下,2B4-CD48 通路共刺激可进一步增强该信号。重要的是,照射 YTS-CAR 细胞可阻止其增殖,却不损害其细胞毒功能,即使经过冷冻和复苏后仍如此。临床前模型中,注射照射后的 YTS-CAR 细胞显著降低 CD19⁺肿瘤负荷,凸显其治疗潜力。本研究将工程化 YTS 细胞确立为一种新型、可规模化且成本较低的“现货型”免疫治疗平台,可用于难治性白血病和淋巴瘤。未来仍需评估其安全性及在自身免疫病和实体瘤中的适用性。
Chimeric antigen receptor (CAR) T cell therapies have revolutionized treatment of hematologic malignancies such as lymphoma and multiple myeloma. However, their success is limited by high manufacturing costs, reliance on autologous T cells, variable product quality, and life-threatening toxicities like cytokine release syndrome. In contrast, natural killer (NK) cells offer a safer, more flexible alternative, but their clinical translation remains constrained by complex expansion protocols and high production costs. Here, we present a transformative approach using the human NK cell line YTS, which is amenable to large-scale culture, genetic manipulation, and cryopreservation. By introducing a CD19-specific CAR into YTS cells, we generate potent effector cells capable of selectively eliminating CD19-expressing targets. We demonstrate that CAR signaling in YTS cells requires intracellular activation and, in certain tumor settings, is enhanced by co-stimulation via the 2B4-CD48 pathway. Importantly, irradiation of YTS-CAR cells prevents proliferation without compromising their cytotoxic function even after freezing and thawing. In preclinical models, injections of irradiated YTS-CAR cells significantly reduced CD19+ tumor burden, underscoring their therapeutic promise. This work positions engineered YTS cells as a novel, scalable, and cost-effective "off-the-shelf" immunotherapy platform suitable for treating refractory leukemias and lymphomas. Future studies will be required to assess safety and to explore applicability to autoimmune diseases and solid tumors.
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