Molecular and Cellular Immunology Unit, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
NIHR Great Ormond Street Hospital Biomedical Research Centre, 30 Guilford Street, London WC1N 1EH, UK.
Mol Ther. 2018 May 2;26(5):1215-1227. doi: 10.1016/j.ymthe.2018.02.025. Epub 2018 Mar 6.
Gene editing can be used to overcome allo-recognition, which otherwise limits allogeneic T cell therapies. Initial proof-of-concept applications have included generation of such "universal" T cells expressing chimeric antigen receptors (CARs) against CD19 target antigens combined with transient expression of DNA-targeting nucleases to disrupt the T cell receptor alpha constant chain (TRAC). Although relatively efficient, transgene expression and editing effects were unlinked, yields variable, and resulting T cell populations heterogeneous, complicating dosing strategies. We describe a self-inactivating lentiviral "terminal" vector platform coupling CAR expression with CRISPR/Cas9 effects through incorporation of an sgRNA element into the ΔU3 3' long terminal repeat (LTR). Following reverse transcription and duplication of the hybrid ΔU3-sgRNA, delivery of Cas9 mRNA resulted in targeted TRAC locus cleavage and allowed the enrichment of highly homogeneous (>96%) CAR (>99%) TCR populations by automated magnetic separation. Molecular analyses, including NGS, WGS, and Digenome-seq, verified on-target specificity with no evidence of predicted off-target events. Robust anti-leukemic effects were demonstrated in humanized immunodeficient mice and were sustained longer than by conventional CARTCR T cells. Terminal-TRAC (TT) CAR T cells offer the possibility of a pre-manufactured, non-HLA-matched CAR cell therapy and will be evaluated in phase 1 trials against B cell malignancies shortly.
基因编辑可用于克服同种异体识别,否则这会限制同种异体 T 细胞疗法。最初的概念验证应用包括生成表达嵌合抗原受体 (CAR) 的此类“通用”T 细胞,这些受体针对 CD19 靶抗原,并与瞬时表达靶向 DNA 的核酸酶结合,以破坏 T 细胞受体α恒定链 (TRAC)。尽管相对有效,但转基因表达和编辑效果不相关,产量可变,且产生的 T 细胞群体异质,使给药策略复杂化。我们描述了一种自失活的慢病毒“末端”载体平台,通过将 sgRNA 元件掺入 ΔU3 3' 长末端重复序列 (LTR) 来将 CAR 表达与 CRISPR/Cas9 效应结合。在杂交 ΔU3-sgRNA 逆转录和复制后,Cas9 mRNA 的递送导致靶向 TRAC 基因座切割,并允许通过自动化磁性分离富集高度同质 (>96%) CAR (>99%) TCR 群体。分子分析,包括 NGS、WGS 和 Digenome-seq,验证了靶标特异性,没有预测的脱靶事件的证据。在人源化免疫缺陷小鼠中证明了强大的抗白血病作用,并且比传统的 CARTCR T 细胞持续时间更长。末端-TRAC (TT) CAR T 细胞提供了一种预制的、非 HLA 匹配的 CAR 细胞疗法的可能性,并将很快在针对 B 细胞恶性肿瘤的 1 期试验中进行评估。
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