Center for Personal Dynamic Regulomes, Stanford University School of Medicine, Stanford, CA, USA; Parker Institute for Cancer Immunotherapy, Stanford University School of Medicine, Stanford, CA, USA.
Parker Institute for Cancer Immunotherapy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Translational Research in Onco-Hematology and Department of Oncology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Cell. 2020 Oct 1;183(1):126-142.e17. doi: 10.1016/j.cell.2020.08.022. Epub 2020 Sep 21.
CD19-directed immunotherapies are clinically effective for treating B cell malignancies but also cause a high incidence of neurotoxicity. A subset of patients treated with chimeric antigen receptor (CAR) T cells or bispecific T cell engager (BiTE) antibodies display severe neurotoxicity, including fatal cerebral edema associated with T cell infiltration into the brain. Here, we report that mural cells, which surround the endothelium and are critical for blood-brain-barrier integrity, express CD19. We identify CD19 expression in brain mural cells using single-cell RNA sequencing data and confirm perivascular staining at the protein level. CD19 expression in the brain begins early in development alongside the emergence of mural cell lineages and persists throughout adulthood across brain regions. Mouse mural cells demonstrate lower levels of Cd19 expression, suggesting limitations in preclinical animal models of neurotoxicity. These data suggest an on-target mechanism for neurotoxicity in CD19-directed therapies and highlight the utility of human single-cell atlases for designing immunotherapies.
CD19 导向的免疫疗法在治疗 B 细胞恶性肿瘤方面具有临床疗效,但也会导致很高的神经毒性发生率。接受嵌合抗原受体 (CAR) T 细胞或双特异性 T 细胞衔接器 (BiTE) 抗体治疗的患者中,有一部分会出现严重的神经毒性,包括与 T 细胞浸润大脑相关的致命性脑水肿。在这里,我们报告称,围绕在内皮细胞周围并对血脑屏障完整性至关重要的壁细胞表达 CD19。我们使用单细胞 RNA 测序数据确定了大脑壁细胞中的 CD19 表达,并在蛋白质水平上确认了血管周围的染色。大脑中的 CD19 表达在壁细胞谱系出现的早期就开始了,并在整个成年期在大脑区域中持续存在。小鼠壁细胞表现出较低水平的 Cd19 表达,这表明在神经毒性的临床前动物模型中存在局限性。这些数据表明 CD19 导向疗法的神经毒性存在一种针对靶点的机制,并突出了人类单细胞图谱在设计免疫疗法方面的实用性。
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