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表位先导编辑可保护造血细胞免受 CD123 免疫疗法治疗急性髓系白血病。

Epitope prime editing shields hematopoietic cells from CD123 immunotherapy for acute myeloid leukemia.

机构信息

Department of Rheumatology and Immunology, Medical Research Institute, Frontier Science Center for Immunology and Metabolism, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, China.

Departments of Clinical Laboratory and Department of Urology, Medical Research Institute, Frontier Science Center for Immunology and Metabolism, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; TaiKang Centre for Life and Medical Sciences, TaiKang Medical School, Wuhan University, Wuhan 430071, China; State Key Laboratory of Virology, Wuhan University, Wuhan 430071, China.

出版信息

Cell Stem Cell. 2024 Nov 7;31(11):1650-1666.e8. doi: 10.1016/j.stem.2024.09.003. Epub 2024 Sep 30.

Abstract

Acute myeloid leukemia (AML) is a malignant cancer characterized by abnormal differentiation of hematopoietic stem and progenitor cells (HSPCs). While chimeric antigen receptor T (CAR-T) cell immunotherapies target AML cells, they often induce severe on-target/off-tumor toxicity by attacking normal cells expressing the same antigen. Here, we used base editors (BEs) and a prime editor (PE) to modify the epitope of CD123 on HSPCs, protecting healthy cells from CAR-T-induced cytotoxicity while maintaining their normal function. Although BE effectively edits epitopes, complex bystander products are a concern. To enhance precision, we optimized prime editing, increasing the editing efficiency from 5.9% to 78.9% in HSPCs. Epitope-modified cells were resistant to CAR-T lysis while retaining normal differentiation and function. Furthermore, BE- or PE-edited HSPCs infused into humanized mice endowed myeloid lineages with selective resistance to CAR-T immunotherapy, demonstrating a proof-of-concept strategy for treating relapsed AML.

摘要

急性髓系白血病 (AML) 是一种恶性癌症,其特征是造血干细胞和祖细胞 (HSPCs) 的异常分化。嵌合抗原受体 T (CAR-T) 细胞免疫疗法针对 AML 细胞,但通过攻击表达相同抗原的正常细胞,常引起严重的靶标内/靶标外毒性。在这里,我们使用碱基编辑器 (BEs) 和 Prime 编辑器 (PE) 修饰 HSPCs 上 CD123 的表位,使健康细胞免受 CAR-T 诱导的细胞毒性,同时保持其正常功能。尽管 BE 有效地编辑了表位,但复杂的旁观者产物是一个问题。为了提高精度,我们优化了 Prime 编辑,将 HSPCs 中的编辑效率从 5.9%提高到 78.9%。修饰表位的细胞对 CAR-T 裂解具有抗性,同时保留正常的分化和功能。此外,输注到人源化小鼠中的 BE 或 PE 编辑的 HSPCs 赋予髓系细胞对 CAR-T 免疫疗法的选择性抗性,为治疗复发性 AML 提供了一种概念验证策略。

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