Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland.
Department of Pharmaceutical Sciences, Division of Molecular and Systems Toxicology, University of Basel, Basel, Switzerland.
Oncoimmunology. 2022 Feb 14;11(1):2039432. doi: 10.1080/2162402X.2022.2039432. eCollection 2022.
T cell engagers represent a novel promising class of cancer-immunotherapies redirecting T cells to tumor cells and have some promising outcomes in the clinic. These molecules can be associated with a mode-of-action related risk of cytokine release syndrome (CRS) in patients. CRS is characterized by the rapid release of pro-inflammatory cytokines such as TNF-α, IFN-γ, IL-6 and IL-1β and immune cell activation eliciting clinical symptoms of fever, hypoxia and hypotension. In this work, we investigated the biological mechanisms triggering and amplifying cytokine release after treatment with T cell bispecific antibodies (TCBs) employing an co-culture assay of human PBMCs or total leukocytes (PBMCs + neutrophils) and corresponding target antigen-expressing cells with four different TCBs. We identified T cells as the triggers of the TCB-mediated cytokine cascade and monocytes and neutrophils as downstream amplifier cells. Furthermore, we assessed the chronology of events by neutralization of T-cell derived cytokines. For the first time, we demonstrate the contribution of neutrophils to TCB-mediated cytokine release and confirm these findings by single-cell RNA sequencing of human whole blood incubated with a B-cell depleting TCB. This work could contribute to the construction of mechanistic models of cytokine release and definition of more specific molecular and cellular biomarkers of CRS in the context of treatment with T-cell engagers. In addition, it provides insight for the elaboration of prophylactic mitigation strategies that can reduce the occurrence of CRS and increase the therapeutic index of TCBs.
T 细胞衔接器代表了一类有前途的癌症免疫疗法,它可以将 T 细胞重新定向到肿瘤细胞上,并在临床上取得了一些有希望的结果。这些分子可能与患者中细胞因子释放综合征(CRS)的作用模式相关风险相关。CRS 的特征是 TNF-α、IFN-γ、IL-6 和 IL-1β等促炎细胞因子的快速释放,以及免疫细胞的激活,引发发热、缺氧和低血压等临床症状。在这项工作中,我们使用人 PBMC 或总白细胞(PBMC+中性粒细胞)与四种不同的 T 细胞双特异性抗体(TCBs)表达相应靶抗原的细胞共培养测定,研究了治疗后触发和放大细胞因子释放的生物学机制。我们确定 T 细胞是 TCB 介导的细胞因子级联反应的触发因素,单核细胞和中性粒细胞是下游放大细胞。此外,我们通过中和 T 细胞衍生的细胞因子来评估事件的时间顺序。我们首次证明了中性粒细胞在 TCB 介导的细胞因子释放中的作用,并通过用 B 细胞耗竭 TCB 孵育的人全血的单细胞 RNA 测序证实了这些发现。这项工作有助于构建细胞因子释放的机制模型,并定义 T 细胞衔接器治疗中 CRS 的更具体的分子和细胞生物标志物。此外,它为制定预防缓解策略提供了思路,这些策略可以降低 CRS 的发生,并提高 TCB 的治疗指数。
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