TNFα 和 IL1β 阻断在 CAR-T 治疗中改善内皮细胞激活的 CRS/ICANS 的治疗潜力
Therapeutic Potential of TNFα and IL1β Blockade for CRS/ICANS in CAR-T Therapy Ameliorating Endothelial Activation.
机构信息
Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Immunol. 2021 May 19;12:623610. doi: 10.3389/fimmu.2021.623610. eCollection 2021.
Severe cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) strongly hampered the broad clinical applicability of chimeric antigen receptor T cell (CAR-T) therapy. Vascular endothelial activation has been suggested to contribute to the development of CRS and ICANS after CAR-T therapy. However, therapeutic strategies targeting endothelial dysfunction during CAR-T therapy have not been well studied yet. Here, we found that tumor necrosis factor α (TNFα) produced by CAR-T cells upon tumor recognition and interleukin 1β (IL1β) secreted by activated myeloid cells were the main cytokines in inducing endothelial activation. Therefore, we investigated the potential effectiveness of TNFα and IL1β signaling blockade on endothelial activation in CAR-T therapy. The blockade of TNFα and IL1β with adalimumab and anti-IL1β antibody respectively, as well as the application of focal adhesion kinase (FAK) inhibitor, effectively ameliorated endothelial activation induced by CAR-T, tumor cells, and myeloid cells. Moreover, adalimumab and anti-IL1β antibody exerted synergistic effect on the prevention of endothelial activation induced by CAR-T, tumor cells, and myeloid cells. Our results indicate that TNFα and IL1β blockade might have therapeutic potential for the treatment of CAR-T therapy-associated CRS and neurotoxicity.
严重的细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)极大地阻碍了嵌合抗原受体 T 细胞(CAR-T)疗法的广泛临床应用。血管内皮细胞激活被认为有助于 CAR-T 治疗后 CRS 和 ICANS 的发展。然而,针对 CAR-T 治疗期间内皮功能障碍的治疗策略尚未得到充分研究。在这里,我们发现 CAR-T 细胞在识别肿瘤时产生的肿瘤坏死因子α(TNFα)和激活的髓样细胞分泌的白细胞介素 1β(IL1β)是诱导内皮细胞激活的主要细胞因子。因此,我们研究了 TNFα 和 IL1β 信号通路阻断在 CAR-T 治疗中对内皮细胞激活的潜在有效性。用阿达木单抗和抗 IL1β 抗体分别阻断 TNFα 和 IL1β,以及应用粘着斑激酶(FAK)抑制剂,有效改善了 CAR-T、肿瘤细胞和髓样细胞诱导的内皮细胞激活。此外,阿达木单抗和抗 IL1β 抗体对预防 CAR-T、肿瘤细胞和髓样细胞诱导的内皮细胞激活具有协同作用。我们的结果表明,TNFα 和 IL1β 阻断可能具有治疗 CAR-T 治疗相关 CRS 和神经毒性的潜力。