针对B细胞和长寿等离子体细胞的免疫疗法有效地消除了先前存在的供体特异性合抗体
Zheng Zhang1, Caroline Markmann2, Ming Yu3
1Department of Pathology & Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Center for Cellular Immunotherapies, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA; Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
针对CD19和BCMA的化学抗原受体 (CAR) T细胞疗法通过耗尽记忆B细胞和血细胞有效地消除了抗人类白细胞抗原 (HLA) 合抗体,改善了岛屿移植结果.
科学领域:
- 免疫学 免疫学 免疫学
- 移植免疫学 移植免疫学
- 细胞疗法是一种细胞疗法.
背景情况:
- 已经存在的抗人类白细胞抗原 (HLA) 抗体是器官移植的重要障碍.
- 目前的脱敏方法不足以消除特异性记忆B细胞和长寿等离子体细胞.
研究的目的:
- 评估针对CD19和B细胞成熟抗原 (BCMA) 的奇美抗原受体 (CAR) T细胞在消除合抗体方面的疗效.
- 评估在接受移植的高度敏感患者中对CAR T细胞疗法进行脱敏.
主要方法:
- 利用小岛合移植的小鼠模型与预先敏感的宿主.
- 服用针对CD19和BCMA的CAR-T细胞,以消除B细胞群.
- 在小鼠模型中评估了捐赠者特异性抗体 (DSA) 水平和超急性排斥.
- 在多发性骨髓瘤患者中评估的临床疗效,这些患者具有先前存在的HLA抗体,并接受CART-BCMA和CART-19治疗.
主要成果:
- 针对记忆B细胞和长寿等离子体细胞的CAR T细胞治疗在小鼠模型中成功消除了DSA.
- 这种CAR T细胞疗法在小鼠中缓解了岛屿异位移植的过敏排斥.
- 在接受组合CAR T细胞治疗的多发性骨髓瘤患者中观察到alo-抗体的临床上有意义的减少.
结论:
- 针对CD19和BCMA的CAR T细胞免疫疗法在消除抗体和预防超急性排斥方面表现出有效性.
- 这种方法在高度敏感的移植候选人中显示出对脱敏的希望.
- 对CAR T细胞疗法的进一步临床评估是有必要的,以促进高风险个体的成功移植.
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