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靶向诱导递送免疫激活细胞因子重塑胶质母细胞瘤微环境并抑制小鼠模型中的生长。

Targeted inducible delivery of immunoactivating cytokines reprograms glioblastoma microenvironment and inhibits growth in mouse models.

机构信息

San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Vita-Salute San Raffaele University, 20132 Milan, Italy.

出版信息

Sci Transl Med. 2022 Jul 13;14(653):eabl4106. doi: 10.1126/scitranslmed.abl4106.

Abstract

Glioblastoma multiforme (GBM) is the most common and lethal brain tumor characterized by a strongly immunosuppressive tumor microenvironment (TME) that represents a barrier also for the development of effective immunotherapies. The possibility to revert this hostile TME by immunoactivating cytokines is hampered by the severe toxicity associated with their systemic administration. Here, we exploited a lentiviral vector-based platform to engineer hematopoietic stem cells ex vivo with the aim of releasing, via their tumor-infiltrating monocyte/macrophage progeny, interferon-α (IFN-α) or interleukin-12 (IL-12) at the tumor site with spatial and temporal selectivity. Taking advantage of a syngeneic GBM mouse model, we showed that inducible release of IFN-α within the TME achieved robust tumor inhibition up to eradication and outperformed systemic treatment with the recombinant protein in terms of efficacy, tolerability, and specificity. Single-cell RNA sequencing of the tumor immune infiltrate revealed reprogramming of the immune microenvironment toward a proinflammatory and antitumoral state associated with loss of a macrophage subpopulation shown to be associated with poor prognosis in human GBM. The spatial and temporal control of IL-12 release was critical to overcome an otherwise lethal hematopoietic toxicity while allowing to fully exploit its antitumor activity. Overall, our findings demonstrate a potential therapeutic approach for GBM and set the bases for a recently launched first-in-human clinical trial in patients with GBM.

摘要

多形性胶质母细胞瘤(GBM)是最常见和最致命的脑肿瘤,其特征是强烈的免疫抑制性肿瘤微环境(TME),这也是有效免疫疗法发展的障碍。通过免疫激活细胞因子来逆转这种敌对的 TME 的可能性受到其全身给药相关的严重毒性的阻碍。在这里,我们利用基于慢病毒载体的平台对造血干细胞进行体外工程改造,目的是通过其肿瘤浸润的单核细胞/巨噬细胞前体在肿瘤部位时空选择性地释放干扰素-α(IFN-α)或白细胞介素-12(IL-12)。利用同源性 GBM 小鼠模型,我们表明在 TME 中诱导释放 IFN-α可实现强大的肿瘤抑制作用,直至根除,并在疗效、耐受性和特异性方面优于重组蛋白的全身治疗。对肿瘤免疫浸润物的单细胞 RNA 测序显示,免疫微环境向促炎和抗肿瘤状态的重编程与一种巨噬细胞亚群的丧失有关,这种巨噬细胞亚群与人类 GBM 的预后不良有关。IL-12 释放的时空控制对于克服否则致命的造血毒性至关重要,同时可以充分利用其抗肿瘤活性。总的来说,我们的研究结果为 GBM 提供了一种潜在的治疗方法,并为最近在 GBM 患者中启动的首例人体临床试验奠定了基础。

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