Arcangeli Silvia, Rotiroti Maria Caterina, Bardelli Marco, Simonelli Luca, Magnani Chiara Francesca, Biondi Andrea, Biagi Ettore, Tettamanti Sarah, Varani Luca
Centro Ricerca Tettamanti, Clinica Pediatrica, Università Milano Bicocca, Ospedale San Gerardo/Fondazione MBBM, 20900 Monza, Italy.
Istituto di Ricerca in Biomedicina, Università degli Studi della Svizzera Italiana, 6500 Bellinzona, Switzerland.
Mol Ther. 2017 Aug 2;25(8):1933-1945. doi: 10.1016/j.ymthe.2017.04.017. Epub 2017 May 4.
Chimeric antigen receptor (CAR)-redirected T lymphocytes are a promising immunotherapeutic approach and object of pre-clinical evaluation for the treatment of acute myeloid leukemia (AML). We developed a CAR against CD123, overexpressed on AML blasts and leukemic stem cells. However, potential recognition of low CD123-positive healthy tissues, through the on-target, off-tumor effect, limits safe clinical employment of CAR-redirected T cells. Therefore, we evaluated the effect of context-dependent variables capable of modulating CAR T cell functional profiles, such as CAR binding affinity, CAR expression, and target antigen density. Computational structural biology tools allowed for the design of rational mutations in the anti-CD123 CAR antigen binding domain that altered CAR expression and CAR binding affinity without affecting the overall CAR design. We defined both lytic and activation antigen thresholds, with early cytotoxic activity unaffected by either CAR expression or CAR affinity tuning but later effector functions impaired by low CAR expression. Moreover, the anti-CD123 CAR safety profile was confirmed by lowering CAR binding affinity, corroborating CD123 is a good therapeutic target antigen. Overall, full dissection of these variables offers suitable anti-CD123 CAR design optimization for the treatment of AML.
嵌合抗原受体(CAR)重定向的T淋巴细胞是一种很有前景的免疫治疗方法,也是治疗急性髓系白血病(AML)临床前评估的对象。我们开发了一种针对CD123的CAR,CD123在AML原始细胞和白血病干细胞上过度表达。然而,通过靶向非肿瘤效应,CAR重定向的T细胞可能会识别低CD123阳性的健康组织,这限制了其在临床上的安全应用。因此,我们评估了能够调节CAR T细胞功能谱的上下文相关变量的作用,如CAR结合亲和力、CAR表达和靶抗原密度。计算结构生物学工具能够在抗CD123 CAR抗原结合域中设计合理的突变,这些突变可改变CAR表达和CAR结合亲和力,而不影响整体CAR设计。我们确定了裂解和激活抗原阈值,早期细胞毒性活性不受CAR表达或CAR亲和力调节的影响,但后期效应功能会因低CAR表达而受损。此外,通过降低CAR结合亲和力证实了抗CD123 CAR的安全性,证实CD123是一个良好的治疗靶点抗原。总体而言,对这些变量的全面剖析为治疗AML提供了合适的抗CD123 CAR设计优化方案。