CN115461361A - 嵌合抗原受体和携带该受体的经修饰的细胞 - Google Patents
嵌合抗原受体和携带该受体的经修饰的细胞 Download PDFInfo
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Abstract
本公开涉及一种嵌合抗原受体(CAR),该嵌合抗原受体(CAR)包含胞外结构域,该胞外结构域具有待布置在修饰的T细胞的质膜表面上的CD19特异性抗原结合结构域,该抗原结合结构域包含可变轻链区和可变重链区,可变轻链区和可变重链区通过接头以端到端方式连接;胞内结构域,用于调节修饰的T细胞活化;跨膜结构域,锚定在修饰的T细胞的质膜上并介于胞外结构域和胞内结构域之间。优选地,胞外结构域通过IgG2间隔区与胞内结构域连接。
Description
技术领域
本公开涉及工程改造的嵌合抗原受体,其能够与在B淋巴细胞或B淋巴细胞谱系细胞表面上表达的分化簇19分子(CD 19)相互作用。此外,本公开还包括基因工程细胞,特别是免疫原性T细胞,其中赋予这些细胞表达和携带嵌合抗原受体的能力。
背景技术
B细胞急性淋巴细胞白血病(B细胞ALL)是最常见的儿童癌症,总体预后良好,高达90%的患者在诊断患有ALL后存活5年。然而,对于那些在治疗中复发的患者,或患有化疗难治性疾病,前景不佳。异基因造血干细胞移植(allo-HSCT)仍提供了治愈的机会,但不幸的是,在通过allo-HSCT治疗白血病后复发很常见。allo-HSCT后复发的ALL患者非常难以管理,除了化疗之外,许多研究人员还提倡将供体淋巴细胞输注作为一种有效的辅助手段,尽管现有数据不支持将其用于患有明显活动性疾病的患者身上。因此,复发/难治性B细胞ALL的新治疗策略至关重要。在这种情况下,CD19是免疫治疗的一个极具吸引力的靶点,因为它的表达几乎普遍存在于B细胞ALL的原始细胞中,但它仅限于B谱系的正常细胞。2随后通过CD19抗原的T细胞受体的修饰开发了嵌合抗原受体(CAR)T细胞制剂,用于治疗难治性B细胞ALL和晚期B细胞淋巴瘤。3
CAR修饰的T细胞的基本结构由来自单克隆抗体的细胞外抗原结合结构域和来自T细胞受体的信号结构域组成,以提供靶向特定表面抗原的能力。第二代和第三代CAR包含一种或两种共刺激分子,例如CD28、4-1BB或OX40,4促进体内扩增。5除了共刺激分子之外,CAR的另一个元素,即间隔结构域(CH2CH3),似乎在介导抗肿瘤活性方面发挥重要作用。据报道,具有突变CH2区域或不具有CH2区域的CAR在鼠模型中赋予T细胞持久性和更有效的抗肿瘤反应。4其他研究人员证明了CAR间隔区长度在受体与其靶抗原结合中的作用。6.7这种CAR修饰T细胞的过继性T细胞转移已成为癌症免疫治疗的新前沿。该领域迅速进入多项临床试验,并使美国FDA批准了用于治疗B细胞ALL和难治性淋巴瘤的前两种CAR T细胞制剂。8事实上,CD19 CAR T细胞已在一些试验中显示出卓越的抗肿瘤作用,高达80%的患者达到完全缓解(CR)。5,9,10但是,应仔细考虑有关CAR T细胞治疗的新出现的安全问题。CAR T细胞输注后的毒性包括细胞因子释放综合征(CRS)、神经毒性和“靶向/脱靶肿瘤”识别,这些都是最严重的毒性,可能会变成危及生命甚至致命的不良事件。11.废除这些不良事件已成为成功实施CAR T细胞作为复发/难治性ALL标准治疗的一部分的另一个挑战。
尽管取得了惊人的临床反应,并且两种产品获得了监管部门的批准,但重要的是要记住,除了存在与制剂相关的可能危及生命的不良反应外,还存在与这种前沿疗法的大规模商业化相关的其它问题。首先,CAR T细胞的成本远高于CAR T细胞的生产成本。12其次,涉及长途运输新鲜淋巴细胞制剂和最终CAR T细胞产品的生产会产生困难的物流问题。这些问题无疑将促使当地医疗(研究)中心开发自己的CAR T制造设施,以便在每个国家或大国的几个不同地区提供此类治疗方案。
对CAR进行的进一步研究,包括国际专利公开WO/2018/231871公开了工程改造T细胞,这些T细胞被配置为在T细胞抗原的内源性表达减少或敲低时表达CAR。Mcginness等人在国际专利公开WO2020037066中详细介绍了另一个关于基因工程改造的造血细胞的类似研究,这些造血细胞表达一种或多种克雷布斯循环调节多肽,以及任选地能够结合目标靶抗原的嵌合受体多肽。Mcginness等人在国际专利公开W02020051493中还进一步描述了另一种基因工程改造的造血细胞,这些造血细胞表达一种或多种能够结合目标靶抗原的乳酸调节因子。虽然WO2020037066A1和WO2020051493A1都教导了源自CD28、CD16A、CD8a或免疫球蛋白G(IgG)的任何铰链或间隔结构域在组装能够结合特定抗原的CAR中的潜在用途,但是这些公开内容中从未确定合适类型的免疫球蛋白G(IgG))。
鉴于在如上所述进行的先前研究中发现的不足之处,需要探究可用于获得性能改进的治疗性CAR系统的其他替代方案。
发明内容
本公开旨在提供一种CAR,其被配置为结合到在给定细胞类型或细胞谱系的表面上表达的特定抗原上,从而使受试者获得有益结果,特别是治疗结果。
本公开的进一步目的涉及一种CAR,其特别设计成识别并结合在B淋巴细胞或B谱系细胞表面上表达的CD 19上,适用于治疗B细胞ALL。具体地,所公开的CAR利用修饰的铰链或间隔结构域来更有效地杀伤B淋巴细胞或B谱系细胞,以治疗B细胞ALL等疾病。
本公开的又一个目的是获得能够表达和呈递所公开的CAR的T细胞,其结合到通过CAR在细胞表面上可获得的相容抗原上导致启动一种或多种优选的免疫反应以根除与B细胞淋巴瘤相关的癌细胞。
本公开的更多目的是提供一种病毒载体,该病毒载体掺入了一种或多种编码所公开的CAR的肽的多核苷酸序列。所公开的载体设计成在相容的转导细胞中表达所编码的肽,这些肽进一步组装到所公开的CAR中。
本公开内容全部或部分满足前述目的中的至少一个目的,其中本公开内容的实施例之一是嵌合抗原受体(CAR),其包含胞外结构域,胞外结构域具有待置于修饰的T细胞质膜表面上的抗原结合结构域,该抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;胞内结构域,用于调节修饰的T细胞活化;跨膜结构域,锚定在修饰的T细胞的质膜上并介于胞外结构域和胞内结构域之间。可变重链区通过间隔区与胞内结构域连接,该间隔区包含与SEQ ID No.1所示序列具有至少90%相似性的氨基酸序列。优选地,间隔区是基于免疫球蛋白(Ig)G2的。
对于更多实施例,可变轻链区包含与SEQ ID No.2具有至少90%相似性的氨基酸序列。
对于许多实施例,可变重链区包含与SEQ ID No.3具有至少90%相似性的氨基酸序列。
在若干实施例中,所述接头包含如SEQ ID No.4所示的氨基酸序列。
通常,在一些实施例中,所述胞外结构域包含如SEQ ID No.5所示的氨基酸序列。
此外,在更多实施例中,所述跨膜结构域包含如SEQ ID No.6所示的氨基酸序列。
优选地,在所公开的CAR的一些实施例中,胞内结构域包含与源自CD3ζ链的胞质信号传导结构域偶联的人CD28信号传导结构域,其中CD28信号传导结构域和胞质信号传导结构域可分别包含如SEQ ID No.7和SEQ ID No.8所示的氨基酸序列。
在更多实施例中,所公开的CAR还包含先前连接到可变轻链区的前导序列,并且前导序列具有如SEQ ID No.9所示的氨基酸序列。
本公开的另一方面涉及能够表达嵌合抗原受体的基因工程改造的T细胞,该嵌合抗原受体包含胞外结构域,该胞外结构域具有待置于修饰的T细胞质膜表面上的抗原结合结构域,该抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;胞内结构域,用于调节修饰的T细胞活化;跨膜结构域,锚定在修饰的T细胞的质膜上并介于胞外结构域和胞内结构域之间。优选地,工程改造T细胞中嵌合抗原受体的可变重链区通过间隔区与胞内结构域连接,该间隔区包含与SEQ ID No.1所示序列具有至少90%相似性的氨基酸序列。
根据工程改造T细胞的几个实施例,所述胞外结构域包含如SEQ ID No.5所示的氨基酸序列。
根据工程改造T细胞的更多实施例,所述胞内结构域包含人CD28信号传导结构域,该人CD28信号传导结构域与源自CD3ζ链的胞质信号传导结构域偶联。
根据工程改造T细胞的多个实施例,所述嵌合抗原受体还包含一个前导序列,该前导序列预先连接到可变轻链区,并且该前导序列具有如SEQ ID No.9所示的氨基酸序列。
本公开的另一方面涉及能够促进编码嵌合抗原受体的肽在转导的T细胞中表达的病毒载体。所述病毒载体基本上包含如SEQ ID No.10所示的多核苷酸序列。优选地,病毒载体是慢病毒载体。
优选地,在所述病毒载体的一些实施例中,所编码的肽包含与SEQ ID No.11所示的氨基酸序列至少90%的相似性。
附图说明
图1是CD 19CAR的几个实施例的示意图,其中每个构建体包含CD 19 scFV、预定范围的IgG2间隔区、CD28跨膜结构域、CD28胞内结构域和CD3ζ胞质结构域;
图2是显示用具有短间隔区的CAR转导后活T细胞数量的图,显示转导第1天后的对数期(类似于未转导细胞),而全间隔区和中间间隔区的CAR进入对数转导后2天的增殖期;
图3是显示使用QPCR测量的转导效率百分比的图表,其中使用靶向CD28-CD3ζ区特异性引物的QPCR在源自不同健康供体的CD 19CAR T细胞中检测到基因组DNA中CARCD28-CD3ζ结构域构建体的表达,其中*和#分别代表与NT和CAR全间隔区构建体相比时P<.05的统计学上显著的差异;
图4是靶向CD28-CD3ζ的特异性引物进行QPCR后的琼脂糖凝胶图(产物大小为281bp);
图5是说明CAR T细胞的抗肿瘤活性的图表,使用基于CFSE-7-AAD的细胞毒性测定来研究与不同间隔区长度CD19 CAR T相关的效应物与靶细胞的比率(E/T),其中Raji,RS4,和Sup-B15(CD19表达细胞)用作靶细胞,Jurkat细胞系和PHA原始细胞(CD 19非表达细胞)用作阴性对照,非转导T细胞(NT)用作对照,其中数据代表由五个独立供体产生的CAR T细胞进行的三个独立实验(与NT、全长和中间间隔区长度相比,*,#和$分别代表P<.05,,而与NT相比,**和***代表P<.01和.001的链);
图6是显示在CAR T细胞输注的第14天检查外周血(PB)和骨髓(BM)样品中检测到的CD 19CAR T细胞的凝胶图片(D表示天,+ve表示转导细胞,-ve代表非转导细胞);和
图7显示(a)SEQ ID No.1、(b)SEQ ID No.2、(c)SEQ ID No.3、(d)SEQ ID No.4、(e)SEQ ID No.5、(f)SEQ ID No.6、(g)SEQ ID No.7、(h)SEQ ID No.8,和(i)SEQ ID No.9的氨基酸序列;
图8显示(a)表示为SEQ ID No.10的多核苷酸序列,其编码(b)表示为SEQ IDNo.11的CAR的一个实施例,该多核苷酸序列可以掺入病毒载体中。
具体实施方式
在下文中,将根据优选实施例并参考所附描述和附图来描述本发明。然而,应当理解,参考本公开的优选实施例和附图的描述仅仅是为了便于讨论各种公开的实施例,并且可以设想,本领域的技术人员可以在不背离所述权利要求的范围的情况下设计不同的修改。
如本文所用,在组分浓度、条件、其他测量值等的上下文中,术语“大约”或“约”是指所述值的+/-5%,或所述值的+/-4%,或所述值的+/-3%,或所述值的+/-2%,所述值的+/-1%,或所述值的+/-0.5%,或所述值的+/-0%。
如本文所用,术语“多核苷酸”或“核酸”是指mRNA、RNA、cRNA、cDNA或DNA。该术语通常是指长度大于30个核苷酸残基的寡核苷酸。
在整个说明书中使用的术语“嵌合抗原受体”或“CAR”是指由一种或多种肽组装而成的人造构建体或复合体,包含多个结构域,形成构建体或复合体的结构域中的至少两个结构域的来源不同。
本公开的一个方面涉及一种CAR,其可以采用如图1所示的不同实施例中一般所示的各种布置或配置。特别地,公开的CAR包含胞外结构域,胞外结构域具有待置于修饰的T细胞质膜表面上的抗原结合结构域,该抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;胞内结构域,用于调节修饰的T细胞活化;跨膜结构域,锚定在修饰的T细胞的质膜上并介于胞外结构域和胞内结构域之间。重要的是要注意,所公开的CAR是CD 19特异性的,它在B淋巴细胞或B淋巴细胞谱系的细胞表面普遍表达。因此,携带CD19特异性CAR的工程改造T细胞应有助于通过工程改造T细胞及其偶联识别B淋巴细胞谱系的细胞。工程改造T细胞和B淋巴细胞谱系细胞的偶联可能导致T细胞的活化和相应免疫调节细胞因子的释放,最终杀伤和根除识别的B淋巴细胞谱系细胞。工程改造T细胞和B淋巴细胞谱系细胞之间发生的上述相互作用使所公开的CAR能够使工程改造T细胞具备作为治疗B细胞ALL、类似疾病和/或与之相关的任何并发症的手段的功能。尽管下文描述的CAR通常指代第二代CAR,但所公开的CAR的一些实施例可以包括第三代或第四代CAR。
再次参考图1,所公开的CAR的可变重链区通过间隔区连接至胞内结构域。间隔区通常用于在抗原结合结构域和转导细胞的膜质之间提供足够的空间,使得抗原结合结构域可以在本质上折叠而不受质膜或安装在膜上的任何细胞成分的干扰。尽管先前报告了间隔区的长度可能在确定携带CAR的T细胞用于白血病治疗的效率中起作用,但是本公开的发明人发现间隔区的正确长度实际上影响转导效率,这可能是决定工程改造T细胞治疗效率的另一个重要因素。具体地,所公开的CAR的间隔区是IgG2来源的,或者更具体地,间隔区是人IgG2来源的。在所公开的CAR的一些其他实施例中,间隔区可以是源自人IgG2的连续片段或区域,具有或不具有进一步修饰。对于所公开的CAR的更多实施例,间隔区包含铰链区、CH3区和介于铰链区和CH3区之间的CH2区。此外,本公开的发明人发现,使用源自基于IgG2的铰链区、CH2区和长度约为132个氨基酸的修饰的CH3区的间隔区可以使所公开的CAR在抗B淋巴细胞谱系的癌细胞方面具有更好的临床结果。更优选地,间隔区包含与如SEQ ID No.1所示的序列具有至少90%相似性的氨基酸序列。
对于一些实施例,抗原结合结构域是单链可变片段。
如前所述,抗原结合结构域基本上由通过接头串联连接的可变轻链区和可变重链区组成。更具体而言,在一些实施例中使用的接头可以是柔性GS接头,其基本上由甘氨酸(Gly)和丝氨酸(Ser)残基组成。更优选地,使用对细胞蛋白酶活性具有抗性的G4S或(Gly-Gly-Gly-Gly-Ser)n柔性接头将可变重链区和可变轻链区融合在一起,其中n可以为1至10。(G4S)4优选用于所公开的CAR的一些实施例中以将轻链区和重链区充分隔开而不引起两个分离区之间的任何不希望的相互作用,但仍保留停留在胞外结构域中的抗原结合结构域的抗CD-19特性。因此,在许多优选的实施例中,接头包含如SEQ ID No.4所示的氨基酸序列。所采用的接头将可变轻链区的氨基末端连接到可变重链区的羧基末端。至于可变轻链区和重链区,这些结构域通常分别衍生自小家鼠免疫球蛋白的轻链和重链,根据公开的CAR的实施例进行或不进行进一步修饰。优选地,可变轻链区包含与SEQ ID No.2具有至少90%相似性的氨基酸序列。同样地,可变重链区包含与SEQ ID No.3具有至少90%相似性的氨基酸序列。更具体地,跨越可变轻链区、接头和可变重链区的胞外结构域包含如SEQ ID No.5所示的氨基酸序列。
根据进一步的实施例,所公开的CAR还可包含前导序列或前导肽序列,所述前导序列或前导肽序列在从高尔基复合体分泌后辅助CAR在工程改造T细胞膜上的表达。优选地,前导肽序列预先连接至可变轻链区以将分泌的嵌合肽引导至表面膜以进行表达。前导序列可以包含氨基酸序列,但不限于,如SEQ ID No.9所示的氨基酸序列。
此外,在所公开的CAR的更多实施例中,胞内结构域优选为TCR zeta链或结构,其被配置为在抗原结合结构域与位于B淋巴细胞谱系细胞上的CD 19反应时促进刺激信号的转移以活化T细胞。更具体地,胞内结构域包含人CD28信号传导结构域,人CD28信号传导结构域与源自人CD3ζ-链的胞质信号传导结构域偶联。优选地,CD28信号传导结构域包含如SEQ ID No.7所示的氨基酸序列,而胞质信号传导结构域包含如SEQ ID No.8所示的氨基酸序列。
根据所公开的CAR的多个实施例,跨膜结构域包含如SEQ ID No.6所示的氨基酸序列,其优选地来源于在T细胞表面特异性发现的人CD28。
根据本公开的另一个方面,能够表达CAR的基因工程改造T细胞被配置为与在B淋巴细胞谱系细胞的细胞表面上发现的CD 19偶联,CAR与CD 19结合,引发导致B淋巴细胞谱系的结合细胞被杀死或根除的免疫调节反应的级联。本公开的发明人努力公开一种通过细胞疗法通过组装用于细胞的CD 19特异性嵌合抗原受体来治疗B细胞-ALL的有效手段。如上所述,鉴于掺入了IgG2修饰的CH3结构域的间隔区的应用,所公开的工程改造T细胞具有比识别或鉴定的B淋巴细胞谱系细胞更好的转导效率和杀伤效率。优选地,所公开的工程改造T细胞包含多个嵌合抗原受体,多个嵌合抗原受体基本上包含胞外结构域,该胞外结构域具有待布置在修饰的T细胞质膜表面上的抗原结合结构域,所述抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;用于调节修饰的T细胞活化的细胞内结构域;跨膜结构域,锚定在修饰的T细胞的质膜上并介于胞外结构域和胞内结构域之间。为了提高对B淋巴细胞谱系靶细胞的转导效率和杀伤效率,可变重链区通过间隔区连接到胞内结构域,该间隔区包含与SEQ ID No.1所示的序列具有至少90%相似性的氨基酸序列。
在多个实施例中,所公开的工程改造T细胞的CAR可以包括一段前导序列,该前导序列预先连接到可变轻链区。优选地,前导序列具有如SEQ ID No.9所示的氨基酸序列,使得CAR的分泌肽或多肽可以在工程改造T细胞表面有效表达。重要的是要注意,所公开的工程改造T细胞可以成为通过细胞疗法治疗B细胞白血病患者的工具,从而解决与使用标准化疗药物相关的任何并发症。尽管如此,也可以使用所公开的工程改造T细胞与预定的化疗药物一起进行白血病治疗,以产生所需的治疗结果,同时确保化疗药物引起的副作用最小。
根据所公开的工程改造T细胞的若干实施例,胞外结构域包含如SEQ ID No.5所示的氨基酸序列,其跨越可变轻链区、接头和可变重链区,分别包含如SEQ ID No.2、SEQ IDNo.3和SEQ ID No.4所示的氨基酸序列。
如上所述,在所公开的工程改造T细胞中表达的CAR的胞内结构域包含人CD28信号传导结构域,人CD28信号传导结构域与源自CD3ζ-链的胞质信号传导结构域偶联。
本公开的另一方面涉及能够促进肽表达的病毒载体,其对应于上述公开的CAR的一个或多个实施例。特别地,所公开的病毒载体编码嵌合抗原受体,该嵌合抗原受体可以在预定培养条件下在相容的转导T细胞中表达。所公开的病毒载体包含如SEQ ID No.10所示的多核苷酸序列或碱基序列。可以进一步修饰SEQ ID No.10的编码序列以获得具有改善或改变的性质的CAR,用于治疗B细胞ALL、类似疾病和/或与之相关的任何并发症。因此,所公开的病毒载体的更多实施例包含如SEQ ID No.10所示具有至少90%相似性的多核苷酸序列或碱基序列。所公开的病毒载体可用于产生CD 19-特定的嵌合抗原受体T细胞,通过任何既定的白血病细胞治疗方案,CD 19-特定的嵌合抗原受体T细胞反过来又可用作B细胞白血病患者的治疗方法。此外,由所公开的载体编码的肽可以包含与SEQ ID No.11所示的氨基酸序列至少90%的相似性。优选地,所公开的病毒载体是慢病毒载体。
同样,本公开的一个方面与如上文公开或描述的用作治疗B细胞ALL的药物的基因工程改造T细胞有关。
以下实施例旨在进一步说明本发明,并不意味着将本公开限定于其中所描述的具体实施例。
实施例1
CAR-CD19-TM28-Z和CAR-PSCA-CD28TM-CD28-CD3ζ这两种CAR构建体由美国得克萨斯州细胞和基因治疗中心、贝勒医学院细胞、德克萨斯儿童医院和休斯顿卫理公会医院友情提供。将它们连接在一起以产生第二代抗CD19 scFv-CD28-CD3ζ。使用抗CD 19scFv-CD28-CD3ζ作为模板制备具有不同间隔区长度“中间”和“短”的修饰CAR构建体。中间和短构建体分别具有CH2和CH2CH3缺失。将三种CAR构建体亚克隆到慢病毒载体骨架质粒(pSin-EF2-Puro;Addgene,Watertown,MA,USA)中。
实施例2
在共转染包膜(pMD2.G)和用pSIN-CD19 CAR载体包装(psPAX2)质粒之前将HEK293T细胞接种到聚-D赖氨酸包被的板中(每个10-cm培养皿5×106个细胞)。第二天,使用FuGENE HD转染试剂(Promega,Madison,WI,USA)转染HEK 293T细胞。在转染后48和72小时收集上清液并通过0.45-μm聚醚砜过滤器(Merck Millipore,Burlington,MA,USA)过滤以去除细胞碎片。根据制造商的说明,使用Lenti-X浓缩器(Takara,Shiga,Japan)浓缩慢病毒。简而言之,将上清液与Lenti-X浓缩器以1:3的比例(Lenti-X浓缩器:上清液)混合,并将混合物在4℃下孵育30分钟。接着,将混合物在4℃下以1500x g离心45分钟。将颗粒悬浮在Dulbecco的磷酸盐缓冲盐水(DPBS)(GIBCO;Thermo Fisher Scientific,Inc,Waltham,MA,USA)中,并在-80℃下储存直至使用。
实施例3
人外周血单核细胞(PBMC)获自健康供体,并使用Ficoll-Paque(GE HealthcareBio-Sciences Corp,Piscataway,NJ,USA)通过密度梯度离心分离。该实验得到了与人类受试者研究相关的人权伦理审查委员会、医学院、拉马蒂博迪医院、玛希隆大学的批准(协议ID 03-59-11)。然后将PBMC在含有5%热灭活人AB血清(Sigma-Aldrich Pte Ltd)和重组人IL2200 U(GMP级,CellGenix;CellGenix Inc)的TexMACS GMP培养基(MACS;MiltenyiBiotec)中培养。Raji细胞系(伯基特淋巴瘤)由Dachrit Nilubol助理教授友情提供。Jurkat细胞系(急性T淋巴细胞白血病)由Kovit Pattanapanyasat教授友情提供。RS4和Sup-B15细胞系(急性淋巴细胞白血病)购自美国典型培养物保藏中心(Manassas,VA,USA)。Raji、RS4和Jurkat细胞系在含有10%胎牛血清(FBS)(GIBCO)和1%青霉素/链霉素(GIBCO)的RPMI-1640培养基中培养,而Sup-B15在Iscove改良的Dulbecco培养基(Hyclone,GEHealthcare Life Sciences)中培养,Dulbecco培养基含有20%FBS、1%青霉素/链霉素和0.05mM 2-巯基乙醇(Sigma-Aldrich)。
为了产生同种异体植物血凝素刺激(PHA)胚细胞,在含有10%FBS和1%青霉素/链霉素的RPMI-1640培养基中,用5μg/mL PHA(Invitrogen;Thermo Fisher Scientific,Inc)刺激5x105个PBMC。在第2天加入总共100U/mL IL-2(PeproTech,Rocky Hill,NJ,USA)。PHA胚细胞培养7天。
每2-3天更换一次培养基和IL-2。所有细胞培养物均保持在37℃且处于空气中含5%CO2的完全湿润气氛中。
实施例4
使用抗人CD3(MACS;Miltenyi Biotec)和抗CD28(MACS;Miltenyi Biotec)单克隆抗体刺激T细胞,然后在含有5%热灭活人AB血清和重组人IL2200 U(GMP等级)的TexMACSGMP培养基中培养。在第3天进行转导。
使用RetroNectin(Takara,Shiga,Japan)转导活化的T细胞。在DPBS中以20μg/mL的浓度使用RetroNectin来包被24孔板。将板在室温下孵育2小时,并用DPBS中的2%热灭活人AB血清(Sigma-Aldrich)封闭。然后将板用DPBS洗涤一次。将慢病毒加入500μL完全TexMACS GMP培养基中并加入包被孔中。将含有病毒的包被板在32℃下以2000x g离心1.5小时。接着,将具有IL-2的500μL完全TexMACS GMP培养基中的105个活化T细胞添加到每个孔中,其中终浓度为100U/mL。每2-3天更换一次完全培养基和IL-2。将转导的T细胞培养6天用于细胞毒性测定。
实施例5
使用GenUP gDNA试剂盒(Biotechrabbit,Hennigsdorf,Germany)从转导的CD 19CAR T细胞和未转导的T细胞中提取DNA。根据制造商的说明,使用QPCR Green Master MixLRox(Biotechrabbit)进行定量聚合酶链反应(QPCR)以确定转基因的拷贝数,并使用CLX96实时PCR检测系统(Bio-Rad,Singapore)进行这一操作。本公开使用对CD28CD3ζ结构域特异的引物,使得无论DNA来自用全长、中长还是短长间隔结构域转导的细胞,PCR都将展示相同的产物。每个反应包含100ng基因组DNA,每个实验一式三份进行。CAR拷贝数量化基于与标准曲线的比较。未转导的T细胞的基因组DNA添加有含有转基因的质粒进行连续稀释,以获得标准曲线。
为了研究靶向抗CD19 CAR的有效性,本公开中的所有构建体包括scFv、跨膜和信号传导结构域都是相同的,每个都编码CD28跨膜、CD28信号传导结构域和CD3ζ衍生的信号传导结构域(图1)。转导后检测到T细胞的增殖。慢病毒转导过程对T细胞的生长和活力没有任何不利影响。CAR完整和中间间隔构建体在转导后2天进入对数期生长,而CAR短间隔构建体在转导后24小时内进入对数期增殖(图2)。通过QPCR测量CAR构建体表达作为转导效率的指标。在与靶细胞共培养之前计算所有构建体的CAR拷贝数。所有构建体表达不同的转导效率,全间隔、中间间隔或短间隔分别约为13%、41%或21%(图3)。对来自CAR T细胞和非转导T细胞(NT)细胞的基因组DNA的QPCR产物进行琼脂糖凝胶电泳。各个CAR产物的大小约为281bp,而正如预期的那样,NT对照细胞不表达CAR构建体,如图4所示。
实施例6
使用基于流式细胞术的分析进行细胞毒性测定。效应细胞(T细胞)用浓度为1mM的羧基荧光素二乙酸琥珀酰亚胺酯(CFSE)(Invitrogen;Thermo Fisher Science,Inc)标记。效应细胞与所有靶细胞以1:1、10:1和20:1(效应:靶)的比例共培养过夜。仅具有靶细胞的对照样品用于评估自发性细胞死亡。第二天,收集细胞并用5μL 7-AAD(7-氨基放线菌素D)(eBioscience;Thermo Fisher Scientific,Inc)染色。通过BD FACSVerse流式细胞仪(BDBioscience;San Jose,CA)和BD FACSuite软件(BD Bioscience)进行数据分析。靶细胞被选为CFSE阴性细胞群。靶细胞死亡被确定为具有7-AAD阳性细胞群的CFSE阴性。根据以下等式计算细胞毒活性的百分比:
实施例7
本公开通过使用对CD28CD3ζ结构域特异的相同引物,如第2.5节所述,通过RT-PCR监测外周血和骨髓样本中的CD 19 CAR T细胞。
简而言之,将来自骨髓抽吸样本的200万个细胞与预混合的抗体组合在室温下孵育15分钟。然后,通过添加裂解缓冲液并孵育10分钟来完成红细胞裂解。将所有细胞洗涤两次并重新悬浮在0.5%多聚甲醛中,以便使用BD LSRFortessa(Beckton Dickinson,SanJose,CA,USA)进行采集。微小残留病(MRD)面板是一个14色面板,包含27个白血病相关标志物,包括CD37、CD164、CD58、CD304、CD20、CD81、CD200、CD24、CD10、CD38、CD44、CD79b、CD49f、CD10、CD123、CD73、CD13、CD33、CD15、CD86、CD66c、NG2(7.1)、CD72、CD19、CD10、CD34和CD45。为了分析,在双重歧视后,未成熟B细胞通过使用CD 19、CD79a、CD 10、CD34、CD45、FSC和SSC进行门控。门控未成熟B细胞的免疫表型模式与hematogones模板进行了比较。剩余的成熟B细胞用作内部对照。当与诊断时的正常模板和MRD模式相比,存在两个或多个异常时,MRD视为阳性结果。检测下限为所有有核细胞的0.01%。
为了验证CD 19 CAR T细胞增加的细胞毒性,对三种B细胞AFF细胞系进行了细胞毒性实验,这三种细胞系为Raji、RS4和Sup-B15。使用基于流式细胞术的测定评估未分选的CD 19 CAR T细胞和淋巴瘤细胞的特异性细胞毒性。效应细胞是三种不同构建体——全长、中长和短长的CD 19 CAR T细胞,如图1所示。NT用作阴性对照T细胞。与NT相比,CAR T细胞的所有三种构建体对所有B细胞系都表现出显著增加的细胞毒性(35-50%对<10%)。不同的靶细胞对CD 19 CAR T细胞表现出不同的反应。与NT(图5A)相比,所有构建体均表达了对Raji细胞的高水平杀伤,而短间隔CAR显示出RS4(图5B)和Sup-B15(图5C)细胞系的最高细胞毒性水平。相比之下,NT和所有CAR T细胞构建体对Jurkat(图5D)和PHA胚细胞(图5E)的肿瘤杀伤能力没有显著差异,表明CAR T细胞是CD 19特异性的。
近年来,多项临床试验显示CD 19 CAR T细胞治疗B细胞恶性肿瘤患者取得了令人瞩目的结果。17-20尽管如此,CAR设计的开发是一个持续的过程,以优化临床疗效并最大限度地减少临床这种治疗的毒性。不同的共刺激分子如CD28、4-IBB和OX40已被用于测试CAR T细胞对肿瘤细胞的功效。据报道,其他结构单元,例如CH2CH3间隔结构域,在CAR T细胞在体内的持久性和存活中发挥作用。2即使不同的构建体在共刺激结构域中存在显著差异,这种改变也可能导致观察到的各种B细胞恶性肿瘤患者的整体治疗效果差异,以及CAR T构建体引发不同程度临床不良事件的能力的差异。
几位研究人员7,21-25已经证明,间隔区长度是CAR T细胞效率的关键问题。在该研究中,本公开研究了包含三种不同长度的间隔区的第二代抗CD 19 CAR T细胞;全长(CH2CH3间隔)、“中间”(-/CH3间隔)和“短”(-/-间隔)。本公开在T细胞上表达了所有三种不同长度的间隔区CAR构建体,其中中间长度显示最高的转导效率。
所有三种CAR构建体的抗肿瘤功效和CD 19特异性活性水平相当。我们评估了表达每种构建体的T细胞对具有阳性CD19表达的三种不同靶细胞系(Raji、RS4和Sup-B15)和一种作为对照的CD 19阴性细胞系(Jurkat)的体外杀伤活性。本公开发现,与NT相比,具有完整、中间或短间隔区的CD 19 CAR T细胞不具有更高百分比的特异性Jurkat细胞裂解,而与NT的杀伤效果相比,所有三种类型的CD 19 CAR T细胞具有更高百分比的Raji、RS4和Sup-B15细胞的特异性裂解,E:T比率为10:1。在E:T比率为20:1时,可以清楚地观察到完整、中间和短CD19 CAR T细胞的杀伤效果差异。因此,具有三种构建体中任何一种的修饰的T细胞呈现出CD 19特异性活性。我们的结果与等人先前报道的结果相似,4这表明CD 19CAR T细胞表达具有或不具有CH2CH3间隔区的CAR构建体在体外具有特异性活性,但在体内缺乏抗白血病活性,部分与CD 19无关的毒性与IgG1衍生的CH2CH3间隔区有关。在没有CH2结构域的情况下,CAR构建体在体内消除白血病,无显性毒性。
有趣的是,尽管所有三种CAR构建体的杀伤效果相当,但短CD 19 CAR T细胞对所有表达CD 19的靶细胞显示出最高的杀伤效率,尽管其转导效率低于中间CD 19 CAR T细胞。对于Raji细胞,全CD 19 CAR T细胞和中间CD 19 CAR T细胞均显示出与短CD 19 CAR T细胞相似的部分特异性裂解。然而,它们对RS4和Sup-B 15细胞的杀伤效率低于它们对Raji细胞的杀伤效率,其中RS4和Sup-B 15细胞在其细胞表面表达相对较少的CD19。CAR T细胞杀伤效力的差异可能是靶抗原的存在和抗原表达强度的影响。26然而,与NT相比,表达三种构建体中的任何一种构建体的修饰的T细胞在根除表达CD19细胞方面的效率更高。我们还观察到表达这三种构建体中任何一种构建体的修饰的CAR T细胞都不会杀死同种异体PHA原始细胞。因此,所公开的表达CAR的T细胞似乎对表达CD19的细胞具有特异性,并且对CD19阴性的同种异体细胞具有最小的杀伤作用。
CAR T细胞输注后的CRS是最严重的毒性之一,27-29与进行性免疫激活相关。26, 30Ravanpay等人已经设计了具有三种间隔变体的第二代CAR构建体:这三种间隔变体为全的、中间的和短的。他们报告说,所有三种间隔变体都具有相同的肿瘤溶解活性。短间隔CART细胞诱导最强大的效应细胞因子产生——白细胞介素2、干扰素γ和肿瘤坏死因子α水平,31而全间隔CAR T细胞由于FcγR与小鼠巨噬细胞的结合而缺乏体内效率。4,22因此,本公开选择中间CD 19 CAR T细胞来避免CRS。
实施例9
一名患有B细胞ALL的11岁男孩在参加富有同情心的临床CAR CD 19 T细胞方案之前骨髓复发。他在8年前被诊断出患有B细胞ALL(初始白细胞计数为1.3x106个细胞/μL)。他的细胞遗传学研究显示46,XY。他接受了标准风险ThaiPOG方案的治疗。13两年后,他出现了骨髓复发,他接受了复发性ALL方案(改良的SJCRH复发ALL方案)。14在他完成改良的SJCRH方案的治疗后一个月,他经历第二次骨髓复发。随后,他在英国ALL方案之后接受了复发ALL方案的治疗。15在他达到CR后,他接受了母亲的单倍体HSCT。一年后,他的中枢神经系统(CNS)复发并伴有颅内肿块。他使用基于硼替佐米的方案16获得了新的CR,并且还接受了鞘内化疗和颅脊椎照射。在完成中枢神经系统受累治疗六个月后,他再次出现全身性骨髓复发,原始细胞率为30%。再诱导化疗由硼替佐米、阿糖胞苷和依托泊苷的组合构成,16在一项富有同情心的研究新药(IND)下,他以0.52x106个细胞/公斤体重(0.8x106个总T细胞/kg;65%转染效率中间长度间隔构建体)的剂量以单倍体CD19 CART细胞固定。CAR T细胞治疗后唯一出现的副作用是低烧,但没有移植物抗宿主病或严重CRS的临床症状,因此决定只观察并密切跟踪患者,直到他的低烧消退。CAR T细胞输注后第30天,他被记录为已达到MRD阴性CR,如表1所示,其已持续10多个月。
样本天数 | %CD19 | %白血病原始细胞 | %正常B细胞 |
复发(11天) | 32 | 27 | 5 |
0 | 4.1 | 0.18 | 4.5 |
7 | 0.5 | 0.5 | 0 |
15 | 0 | 0 | 0 |
30 | 0.05 | 0 | 0.05 |
154 | 1 | 0 | 1 |
188 | 3 | 0 | 3 |
注:天0=CD19CAR19 T-细胞输注的天数
表1
关于患有B细胞ALL的患者,本公开的发明人在CAR CD 19T细胞治疗之前给了他一个化疗周期,以减少白血病原始细胞并诱导免疫抑制状态,有利于单倍体CAR T细胞输注。然后,他在富有同情心的使用请求下接受了单倍体CD 19 CAR T细胞。本公开证明了CR的诱导以及保持MRD阴性10+个月的难治性白血病的持续、未维持的缓解。在CD19 CAR T细胞输注后至少2周,通过RT-PCR在外周血和骨髓样本中检测到基因工程改造的CD19 CAR T细胞(图6)。有了这些有利的发现,本公开计划在I-II期环境中研究复发/难治性B细胞ALL患者中的同种异体CD 19 CAR T细胞作为allo-HSCT的桥接疗法,然后进行移植后CAR T细胞加强作为这些高风险患者的巩固治疗,因为本公开内容关注移植前调节化疗对在HSCT之前作为补救治疗施用的CAR T群体的可能有害影响。
应当理解,本发明可以以其他具体形式体现,并不限于上述的唯一实施例。然而,诸如本领域技术人员容易想到的那些公开概念的修改和等价物旨在包括在所附权利要求的范围内。
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Claims (20)
1.一种嵌合抗原受体(CAR),包含:
胞外结构域,胞外结构域具有待置于修饰的T细胞质膜表面上的抗原结合结构域,该抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;
胞内结构域,用于调节所述修饰的T细胞活化;和
跨膜结构域,锚定在所述修饰的T细胞的所述质膜上并介于所述胞外结构域和所述胞内结构域之间,
其中所述可变重链区通过间隔区与所述胞内结构域连接,所述间隔区包含与SEQ IDNo.1所示序列具有至少90%相似性的氨基酸序列。
2.根据权利要求1所述的嵌合受体,其特征在于,所述间隔区是基于IgG2的。
3.根据权利要求1所述的嵌合受体,其特征在于,所述可变轻链区包含与SEQ ID No.2具有至少90%相似性的氨基酸序列。
4.根据权利要求1所述的嵌合受体,其特征在于,所述可变重链区包含与SEQ ID No.3具有至少90%相似性的氨基酸序列。
5.根据权利要求1所述的嵌合受体,其特征在于,所述接头包含如SEQ ID No.4所示的氨基酸序列。
6.根据权利要求1所述的嵌合受体,其特征在于,所述胞外结构域包含如SEQ ID No.5所示的氨基酸序列。
7.根据权利要求1所述的嵌合受体,其特征在于,所述跨膜结构域包含如SEQ ID No.6所示的氨基酸序列。
8.根据权利要求1所述的嵌合受体,其特征在于,所述胞内结构域包含人CD28信号传导结构域,该人CD28信号传导结构域与源自CD3ζ-链的胞质信号传导结构域偶联。
9.根据权利要求8所述的嵌合受体,其特征在于,所述CD28信号传导结构域包含如SEQID No.7所示的氨基酸序列。
10.根据权利要求8所述的嵌合受体,其特征在于,所述胞质信号传导结构域包含如SEQID No.8所示的氨基酸序列。
11.根据权利要求1所述的嵌合受体,其特征在于,还包含一个前导序列,该前导序列预先连接到所述可变轻链区,并且所述前导序列具有如SEQ ID No.9所示的氨基酸序列。
12.根据权利要求1所述的嵌合受体,其特征在于,所述抗原结合结构域是单链可变片段。
13.一种能够表达嵌合抗原受体的基因工程改造的T细胞,所述嵌合抗原受体包含:
胞外结构域,该胞外结构域具有待置于修饰的T细胞质膜表面上的抗原结合结构域,该抗原结合结构域包含通过接头以端对端方式连接的可变轻链区和可变重链区;
胞内结构域,用于调节所述修饰的T细胞活化;以及
跨膜结构域,锚定在所述修饰的T细胞的质膜上并介于所述胞外结构域和所述胞内结构域之间,
其中所述可变重链区通过间隔区与所述胞内结构域连接,该间隔区包含与SEQ IDNo.1所示序列具有至少90%相似性的氨基酸序列。
14.根据权利要求13所述的工程改造T细胞,其特征在于,所述胞外结构域包含如SEQID No.5所示的氨基酸序列。
15.根据权利要求13所述的工程改造T细胞,其特征在于,所述胞内结构域包含人CD28信号传导结构域,该人CD28信号传导结构域与源自CD3ζ-链的胞质信号传导结构域偶联。
16.根据权利要求13所述的工程改造T细胞,其特征在于,所述嵌合抗原受体还包含一个前导序列,该前导序列预先连接到所述可变轻链区,并且该前导序列具有如SEQ ID No.9所示的氨基酸序列。
17.一种能够促进编码嵌合抗原受体的肽在转导的T细胞中表达的病毒载体,其包含如SEQ ID No.10所示的多核苷酸序列。
18.根据权利要求17所述的病毒载体,其特征在于,所述肽包含与SEQ ID No.11所示的氨基酸序列至少90%的相似性。
19.如权利要求17所述的病毒载体是慢病毒载体。
20.如权利要求13-16中任一项所述的基因工程改造的T细胞在B细胞ALL治疗中用作药物。
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