Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.
Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
J Hepatol. 2024 Jun;80(6):913-927. doi: 10.1016/j.jhep.2024.01.034. Epub 2024 Feb 8.
BACKGROUND & AIMS: Treatments directly targeting fibrosis remain limited. Given the unique intrinsic features of macrophages and their capacity to engraft in the liver, we genetically engineered bone marrow-derived macrophages with a chimeric antigen receptor (CAR) to direct their phagocytic activity against hepatic stellate cells (HSCs) in multiple mouse models. This study aimed to demonstrate the therapeutic efficacy of CAR macrophages (CAR-Ms) in mouse models of fibrosis and cirrhosis and to elucidate the underlying mechanisms. METHODS: uPAR expression was studied in patients with fibrosis/cirrhosis and in murine models of liver fibrosis, including mice treated with carbon tetrachloride, a 5-diethoxycarbonyl-1, 4-dihydrocollidine diet, or a high-fat/cholesterol/fructose diet. The safety and efficacy of CAR-Ms were evaluated in vitro and in vivo. RESULTS: Adoptive transfer of CAR-Ms resulted in a significant reduction in liver fibrosis and the restoration of function in murine models of liver fibrosis. CAR-Ms modulated the hepatic immune microenvironment to recruit and modify the activation of endogenous immune cells to drive fibrosis regression. These CAR-Ms were able to recruit and present antigens to T cells and mount specific antifibrotic T-cell responses to reduce fibroblasts and liver fibrosis in mice. CONCLUSION: Collectively, our findings demonstrate the potential of using macrophages as a platform for CAR technology to provide an effective treatment option for liver fibrosis. CAR-Ms might be developed for treatment of patients with liver fibrosis. IMPACT AND IMPLICATIONS: Liver fibrosis is an incurable condition that afflicts millions of people globally. Despite the clear clinical need, therapies for liver fibrosis are limited. Our findings provide the first preclinical evidence that chimeric antigen receptor (CAR)-macrophages (CAR-Ms) targeting uPAR can attenuate liver fibrosis and cirrhosis. We show that macrophages expressing this uPAR CAR exert a direct antifibrotic effect and elicit a specific T-cell response that augments the immune response against liver fibrosis. These findings demonstrate the potential of using CAR-Ms as an effective cell-based therapy for the treatment of liver fibrosis.
背景与目的:针对纤维化的治疗方法仍然有限。鉴于巨噬细胞的独特内在特征及其在肝脏中的植入能力,我们通过嵌合抗原受体 (CAR) 对骨髓来源的巨噬细胞进行基因工程改造,使其吞噬活性针对多种小鼠模型中的肝星状细胞 (HSCs)。本研究旨在证明 CAR 巨噬细胞 (CAR-M) 在纤维化和肝硬化的小鼠模型中的治疗效果,并阐明其潜在机制。
方法:研究了纤维化/肝硬化患者和小鼠肝纤维化模型中 uPAR 的表达,包括用四氯化碳、5-二乙氧基羰基-1,4-二氢吡啶或高脂肪/胆固醇/果糖饮食治疗的小鼠。在体外和体内评估了 CAR-M 的安全性和疗效。
结果:CAR-M 的过继转移导致小鼠肝纤维化模型中的肝纤维化显著减少和功能恢复。CAR-M 调节肝免疫微环境,招募并修饰内源性免疫细胞的激活,以驱动纤维化消退。这些 CAR-M 能够招募和呈递抗原给 T 细胞,并在小鼠中引发特异性抗纤维化 T 细胞反应,以减少成纤维细胞和肝纤维化。
结论:总之,我们的研究结果表明,巨噬细胞作为 CAR 技术的平台具有潜在的应用价值,可以为肝纤维化提供有效的治疗选择。CAR-M 可能被开发用于治疗肝纤维化患者。
影响与意义:肝纤维化是一种全球性的不治之症,影响着数百万人。尽管临床需求明显,但肝纤维化的治疗方法仍然有限。我们的研究结果提供了第一个临床前证据,证明靶向 uPAR 的嵌合抗原受体 (CAR) 巨噬细胞 (CAR-M) 可以减轻肝纤维化和肝硬化。我们表明,表达这种 uPAR CAR 的巨噬细胞发挥直接的抗纤维化作用,并引发增强针对肝纤维化免疫反应的特异性 T 细胞反应。这些发现证明了 CAR-M 作为治疗肝纤维化的有效细胞疗法的潜力。
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