Zhang Xingying, Zhang Chenze, Lu Shan, Dong Jingxi, Tang Na, Wang Yao, Han Weidong, Pan Xi, Zhang Xiang, Liu Duan, Shyh-Chang Ng, Wang Yu, Feng Guihai, Wang Haoyi
State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
National Key Laboratory of Efficacy and Mechanism on Chinese Medicine for Metabolic Diseases, Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China.
Cell Rep Med. 2024 Dec 17;5(12):101869. doi: 10.1016/j.xcrm.2024.101869. Epub 2024 Dec 9.
T cell exhaustion presents a major challenge for the efficacy of both immune checkpoint inhibitors (ICBs) and chimeric antigen receptor T (CAR-T) cell immunotherapies. To address this issue, we generate hypofunctional CAR-T cells that imitate the exhaustion state. By screening a Food and Drug Administration (FDA)-approved small molecule library using this model, we identify miltefosine as a potent molecule that restores the impaired function of CAR-T cells in a PD-1/PD-L1-independent manner. Impressively, in the terminally exhausted state where PD-1 antibody treatment is ineffective, miltefosine still enhances CAR-T cell activity. Single-cell sequencing analysis reveals that miltefosine treatment significantly increases the population of effector cells. Mechanistically, miltefosine improves impaired glycolysis and oxidative phosphorylation in hypofunctional CAR-T cells. In both allogeneic and syngeneic tumor models, miltefosine effectively enhances the solid tumor clearance ability of CAR-T cells and T cells, demonstrating its potential as an effective immunotherapeutic drug.
T细胞耗竭对免疫检查点抑制剂(ICB)和嵌合抗原受体T(CAR-T)细胞免疫疗法的疗效构成了重大挑战。为了解决这个问题,我们生成了模拟耗竭状态的功能低下的CAR-T细胞。通过使用该模型筛选美国食品药品监督管理局(FDA)批准的小分子文库,我们确定米替福新是一种有效的分子,它以不依赖PD-1/PD-L1的方式恢复CAR-T细胞受损的功能。令人印象深刻的是,在PD-1抗体治疗无效的终末耗竭状态下,米替福新仍能增强CAR-T细胞活性。单细胞测序分析表明,米替福新治疗显著增加了效应细胞群体。从机制上讲,米替福新改善了功能低下的CAR-T细胞中受损的糖酵解和氧化磷酸化。在同种异体和同基因肿瘤模型中,米替福新都有效地增强了CAR-T细胞和T细胞清除实体瘤的能力,证明了其作为一种有效免疫治疗药物的潜力。