Department of Medical Oncology, Dana-Farber Cancer Institute, Children's Hospital, Boston, Massachusetts, USA.
Cancer Res. 2010 May 15;70(10):3915-24. doi: 10.1158/0008-5472.CAN-09-3845. Epub 2010 Apr 27.
Allogeneic hematopoietic stem-cell transplantation can cure some patients with high-risk B-cell malignancies, but disease relapse following transplantation remains a significant problem. One approach that could be used to augment the donor T-cell-mediated antitumor effect is the infusion of allogeneic donor-derived T cells expressing a chimeric antibody receptor (CAR) specific to the B-cell antigen CD19. However, the use of such cells might result in toxicity in the form of graft-versus-host disease mediated by CD19-specific (CD19-CAR) T cells possessing alloreactive endogenous T-cell receptors. We therefore investigated whether nonalloreactive tumor-specific human T cells could be generated from peripheral blood mononuclear cells of healthy donors by the combination of CD19 redirection via CAR expression and subsequent alloanergization by allostimulation and concomitant blockade of CD28-mediated costimulation. Alloanergization of CD19-CAR T cells resulted in efficient and selective reduction of alloresponses in both CD4(+) and CD8(+) T cells, including allospecific proliferation and cytokine secretion. Importantly, T-cell effector functions including CAR-dependent proliferation and specific target cytolysis and cytokine production were retained after alloanergization. Our data support the application of CD19 redirection and subsequent alloanergization to generate allogeneic donor T cells for clinical use possessing increased antitumor activity but limited capacity to mediate graft-versus-host disease. Immunotherapy with such cells could potentially reduce disease relapse after allogeneic transplantation without increasing toxicity, thereby improving the outcome of patients undergoing allogeneic transplantation for high-risk B-cell malignancies.
同种异体造血干细胞移植可以治愈一些高危 B 细胞恶性肿瘤患者,但移植后疾病复发仍然是一个重大问题。一种可以增强供体 T 细胞介导的抗肿瘤作用的方法是输注表达嵌合抗体受体 (CAR) 的同种异体供体来源 T 细胞,该受体针对 B 细胞抗原 CD19。然而,使用此类细胞可能会导致由 CD19 特异性(CD19-CAR)T 细胞引起的移植物抗宿主病毒性,这些 T 细胞具有同种反应性内源性 T 细胞受体。因此,我们研究了是否可以通过 CAR 表达介导的 CD19 重定向和随后的同种异体刺激和共阻断 CD28 介导的共刺激来使同种异体耐受力,从健康供体的外周血单核细胞中产生非同种反应性肿瘤特异性人 T 细胞。CD19-CAR T 细胞的同种异体耐受力导致 CD4(+)和 CD8(+)T 细胞中的同种反应均有效且选择性降低,包括同种特异性增殖和细胞因子分泌。重要的是,CAR 依赖性增殖和特定靶标细胞溶解以及细胞因子产生等 T 细胞效应功能在同种异体耐受力后得以保留。我们的数据支持应用 CD19 重定向和随后的同种异体耐受力来产生具有增强的抗肿瘤活性但介导移植物抗宿主病能力有限的同种异体供体 T 细胞用于临床应用。这种细胞的免疫疗法有可能降低同种异体移植后疾病复发的风险,而不会增加毒性,从而改善接受高危 B 细胞恶性肿瘤同种异体移植的患者的预后。
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