Khanal Supreet, Baer Alan, Hossain Md Kamal, Colon-Moran Winston, Panthi Santosh, Bhattarai Nirjal
Tumor Vaccine and Biotechnology Branch, Office of Cellular Therapy and Human Tissues, Office of Therapeutic Products, Center for Biologics Evaluation and Research, United States Food and Drug Administration (U.S. FDA), Silver Spring, MD, United States.
Front Immunol. 2024 Dec 24;15:1519415. doi: 10.3389/fimmu.2024.1519415. eCollection 2024.
INTRODUCTION: CAR-T cell therapy is associated with life-threatening inflammatory toxicities, partly due to the activation and secretion of inflammatory cytokines by bystander myeloid cells (BMCs). However, due to limited clinical data, it is unclear whether CAR-NK cells cause similar toxicities. METHODS: We characterized the soluble factors (SFs) released by activated human CAR-T and CAR-NK cells and assessed their role in BMC activation (BMCA). RESULTS: We found that SFs from both activated, peripheral blood-derived CAR-T (PB-CAR-T) and CAR-NK (PB-CAR-NK) cells induced BMCA; however, PB-CAR-NK cells caused significantly lower BMCA compared to PB-CAR-T cells. Interestingly, SFs from cord-blood-derived (CB) NK cells caused little to no BMCA, consistent with previous clinical studies showing minimal inflammatory toxicity with CB-CAR-NK cells. Comparative analysis of SFs released by PB-NK and PB-CAR-NK cells following CAR-dependent and CAR-independent activation revealed several candidate factors with the potential to cause BMCA. Antibody-mediated neutralization studies identified a combination of four factors that contribute to PB-CAR-NK cell-mediated BMCA. siRNA-mediated knockdown studies confirmed that inactivating these four factors in PB-CAR-NK cells significantly reduces BMCA. Importantly, neutralization or knockdown of these four factors did not affect CAR-NK cell potency. DISCUSSION: These data suggest that specific SFs released by PB-CAR-NK cells activate BMCs and have the potential to contribute to inflammatory toxicities. Furthermore, inactivation of these four factors in PB-CAR-NK cells could reduce inflammatory toxicities and improve safety of PB-CAR-NK cell therapy without compromising potency.
引言:嵌合抗原受体(CAR)T细胞疗法与危及生命的炎性毒性相关,部分原因是旁观者髓样细胞(BMC)激活并分泌炎性细胞因子。然而,由于临床数据有限,尚不清楚CAR-NK细胞是否会引起类似的毒性。 方法:我们对活化的人CAR-T细胞和CAR-NK细胞释放的可溶性因子(SFs)进行了表征,并评估了它们在BMC激活(BMCA)中的作用。 结果:我们发现,来自活化的外周血来源的CAR-T(PB-CAR-T)细胞和CAR-NK(PB-CAR-NK)细胞的SFs均可诱导BMCA;然而,与PB-CAR-T细胞相比,PB-CAR-NK细胞引起的BMCA明显更低。有趣的是,来自脐带血来源(CB)的NK细胞的SFs几乎不会引起BMCA,这与先前的临床研究结果一致,即CB-CAR-NK细胞的炎性毒性极小。对PB-NK细胞和PB-CAR-NK细胞在CAR依赖性和CAR非依赖性激活后释放的SFs进行比较分析,发现了几个可能导致BMCA的候选因子。抗体介导的中和研究确定了四种因子的组合,这些因子促成了PB-CAR-NK细胞介导的BMCA。小干扰RNA(siRNA)介导的敲低研究证实,使PB-CAR-NK细胞中的这四种因子失活可显著降低BMCA。重要的是,中和或敲低这四种因子并不影响CAR-NK细胞的效力。 讨论:这些数据表明,PB-CAR-NK细胞释放的特定SFs可激活BMC,并有可能导致炎性毒性。此外,使PB-CAR-NK细胞中的这四种因子失活可降低炎性毒性,并提高PB-CAR-NK细胞疗法的安全性,而不会影响其效力。
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