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病例报告:CD19 CAR T 细胞治疗后,B 细胞缺陷患者接受恢复期血浆治疗诱导抗 SARS-CoV-2 T 细胞扩增、NK 细胞成熟和病毒清除

Case Report: Convalescent Plasma Therapy Induced Anti-SARS-CoV-2 T Cell Expansion, NK Cell Maturation and Virus Clearance in a B Cell Deficient Patient After CD19 CAR T Cell Therapy.

机构信息

Institute of Immunology, Hannover Medical School, Hannover, Germany.

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.

出版信息

Front Immunol. 2021 Aug 12;12:721738. doi: 10.3389/fimmu.2021.721738. eCollection 2021.

DOI:10.3389/fimmu.2021.721738
PMID:34456929
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8387963/
Abstract

Here, we described the case of a B cell-deficient patient after CD19 CAR-T cell therapy for refractory B cell Non-Hodgkin Lymphoma with protracted coronavirus disease 2019 (COVID-19). For weeks, this patient only inefficiently contained the virus while convalescent plasma transfusion correlated with virus clearance. Interestingly, following convalescent plasma therapy natural killer cells matured and virus-specific T cells expanded, presumably allowing virus clearance and recovery from the disease. Our findings, thus, suggest that convalescent plasma therapy can activate cellular immune responses to clear SARS-CoV-2 infections. If confirmed in larger clinical studies, these data could be of general importance for the treatment of COVID-19 patients.

摘要

在这里,我们描述了一例 B 细胞缺陷患者的情况,该患者在接受抗 CD19 CAR-T 细胞治疗难治性 B 细胞非霍奇金淋巴瘤后,并发了 COVID-19。数周以来,该患者仅能低效地控制病毒,而恢复期血浆输注与病毒清除相关。有趣的是,在接受恢复期血浆治疗后,自然杀伤细胞成熟,病毒特异性 T 细胞扩增,可能导致病毒清除和疾病康复。因此,我们的研究结果表明,恢复期血浆治疗可以激活细胞免疫反应以清除 SARS-CoV-2 感染。如果在更大的临床研究中得到证实,这些数据可能对 COVID-19 患者的治疗具有普遍重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e8/8387963/401baaec96e8/fimmu-12-721738-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e8/8387963/401baaec96e8/fimmu-12-721738-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e8/8387963/401baaec96e8/fimmu-12-721738-g001.jpg

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The Effect of Convalescent Plasma Therapy on Mortality Among Patients With COVID-19: Systematic Review and Meta-analysis.
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Neutralizing monoclonal antibodies for treatment of COVID-19.用于治疗 COVID-19 的中和单克隆抗体。
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Treatment of B-cell depleted COVID-19 patients with convalescent plasma and plasma-based products.用恢复期血浆和基于血浆的产品治疗 B 细胞耗竭的 COVID-19 患者。
Clin Immunol. 2021 Jun;227:108723. doi: 10.1016/j.clim.2021.108723. Epub 2021 Apr 7.
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