使用针对CD19的免疫调节来消灭AAV中和抗体
Bhavya S Doshi1, Caroline A Markmann2, Noelle Novak3
1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Raymond G. Perelman Center for Cellular and Molecular Therapy, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA 30329, USA.
概括
对腺相关病毒 (AAV) 的中和抗体阻碍了基因疗法. CD19 CAR-T细胞疗法在小鼠中有效地消除了这些抗体,使得AAV的成功再注射和转基因表达成为可能.
科学领域:
- 免疫学 免疫学 免疫学
- 基因治疗 基因治疗
- 病毒学 病毒学
背景情况:
- 针对腺相关病毒 (AAV) 的中和抗体 (NAbs) 阻碍了基于AAV的基因疗法的有效性,特别是在载体再给药时.
- 目前的免疫调节策略显示出希望,但了解参与持久NAbs的B细胞子集对于有效根除至关重要.
研究的目的:
- 研究针对CD19的疗法在根除先前存在的AAV NAbs时的有效性.
- 为了比较单克隆抗体 (mAbs) 与仿真抗原受体T (CAR-T) 细胞在消除NAbs和使AAV重新注射方面的有效性.
主要方法:
- 具有高AAV8NAbs标位的小鼠接受了针对CD19,CD22,CD20或B220的组合mAbs的治疗.
- 作为另一种选择,小鼠接受了CD19 CAR-T细胞治疗.
- 评估了对外围和组织居住的B细胞,血细胞和AAV NAb标位的影响,随后进行了系统性的AAV8再给药,以评估转基因表达.
主要成果:
- 组合mAb疗法没有消除组织居住的B细胞或耗尽高位数的AAV8 NAbs.
- CD19 CAR-T疗法成功地消除了外围和组织中存在的B细胞和血细胞.
- CD19 CAR-T疗法导致AAV8 NAbs的显著减少或根除,允许AAV8再给药后成功的转基因表达.
结论:
- 针对CD19的疗法,特别是CD19 CAR-T细胞,通过向外围和组织居住的B细胞和血细胞,有效地消除AAV NAbs.
- 这种方法克服了AAV基因治疗的一个主要障碍,使得成功的载体再注射和持续的转基因表达成为可能.
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