Article
作者: Porazzi, Patrizia ; Behrens, Edward M. ; Wu, Chih Hao ; Jenks, Scott ; Stella, Federico ; Wang, Li-Ping ; Stamatopoulos, Kostas ; Kreitman, Robert J. ; Sanz, Ignacio ; McCuaig, Sarah ; Inghirami, Giorgio ; Tiacci, Enrico ; Espie, David ; Zhang, Yunlin ; Iatrou, Anastasia ; Arons, Evgeny ; Gabrielli, Giulia ; Vlachonikola, Elisavet ; Pajarillo, Raymone ; Schuster, Stephen J. ; Cohen, Ivan J. ; Bugrovsky, Regina ; Paruzzo, Luca ; Bochi-Layec, Audrey C. ; Wherry, E. John ; Ruella, Marco ; Ghia, Paolo ; Bhosale, Aditya ; Kim, Ki Hyun ; Apostolidis, Sokratis A. ; Palmer, Matthew B. ; Kolar, Bronte ; Bouziani, Eleni ; Santi, Alessia ; Bayat, Pedram ; Fulmer, Bria ; Medico, Giovanni ; Ramasubramanian, Ranjani ; Sahinalp, S. Cenk ; Agathangelidis, Andreas ; Harris, Jaryse ; Bhoj, Vijay ; Lemoine, Jean ; Ghilardi, Guido ; Ugwuanyi, Ositadimma ; Zhao, Huiwu ; Karipidou, Maria ; Day, Chi-Ping ; Kreiger, Portia A. ; Cases, Marcos ; Guruprasad, Puneeth
Current US Food and Drug Administration–approved chimeric antigen receptor (CAR) T cell therapies for B cell leukemias and lymphomas target CD19, which is widely expressed across the B cell lineage, often leading to on-target, off-tumor B cell depletion, prolonged immune suppression, and antigen-negative escape in a subset of patients. In contrast, B cell receptor (BcR) signaling is essential for the survival of most mature B cell neoplasms, and BcRs carrying the immunoglobulin heavy variable gene
IGHV4-34
are highly enriched in B cell malignancies compared with normal B cells. Further, self-reactive IGHV4-34
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serum autoantibodies are enriched in aggressive systemic lupus erythematosus (SLE) and other autoimmune diseases. Here, we developed CAR T cells targeting the BcR carrying IGHV4-34 (CART4-34). We found that CART4-34 showed specific cytotoxicity and cytokine secretion toward IGHV4-34
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malignant B cells. In addition, although CD19 was down-regulated upon relapse after treatment with CART19, IGHV4-34
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BcR levels remained intact upon relapse after treatment with CART4-34, suggesting reduced risk of antigen-negative escape. In IGHV4-34
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HBL1 cell line–derived xenograft mouse models, CART4-34 showed robust expansion and antitumor activity comparable to those of CART19. Optimized CAR:BcR binding using shorter CAR hinge domains improved immune synapse morphology and in vivo activity. In addition, we showed that CART4-34 could target human IGHV4-34
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SLE B cells and deplete IGHV4-34
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autoantibodies ex vivo, without targeting healthy B cells or affecting total IgG titers. In conclusion, we developed a CAR T cell product that specifically targets pathogenic B cells in lymphoid malignancies and SLE, offering potential for precision cell therapy for these indications.