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WO2018053885A1 - Procédé de préparation et d'utilisation de cellules car-t slit2 améliorées et de cellules car-nk - Google Patents

Procédé de préparation et d'utilisation de cellules car-t slit2 améliorées et de cellules car-nk Download PDF

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WO2018053885A1
WO2018053885A1 PCT/CN2016/101751 CN2016101751W WO2018053885A1 WO 2018053885 A1 WO2018053885 A1 WO 2018053885A1 CN 2016101751 W CN2016101751 W CN 2016101751W WO 2018053885 A1 WO2018053885 A1 WO 2018053885A1
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car
cells
gene
seq
hac
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李华顺
王保垒
任宝永
方冬冬
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Definitions

  • the present invention relates to the field of biotechnology, and in particular to a chimeric antigen receptor cell against an anti-tumor stem cell, particularly a boosted CAR-T cell and a boosted CAR-NK cell.
  • PD-L1 full-length programmed death receptor-ligand 1 the English name programmed cell death-Ligand 1
  • PD-1 the full name of programmed death receptor 1, the English name for programmed death 1
  • PD-1 is an important immunosuppressive molecule and is a member of the CD28 superfamily.
  • PD-1 (programmed death-1) is mainly expressed on the surface of T cells and primary B cells, and two ligands of PD-1 (PD-L1 and PD-L2) are widely expressed in antigen-presenting cells (APCs).
  • APCs antigen-presenting cells
  • the interaction of PD1 with its receptor plays an important role in the negative regulation of immune response.
  • the expression of PD-L1 protein can be detected in many human tumor tissues.
  • the microenvironment of the tumor site can induce the expression of PD-L1 on tumor cells.
  • the expression of PD-L1 is beneficial to the occurrence and growth of tumors, and induces anti-tumor.
  • the apoptosis of T cells evades the attack of the immune system. Inhibition of the binding of PD-1 to its ligand can expose tumor cells to the killing field of the immune system, thereby achieving the effect of killing tumor tissue and treating cancer.
  • CAR-T Chimeric Antigen Receptor T-Cell Immunotherapy
  • the therapy is a new type of cell therapy that has been in clinical use for many years but has been improved in recent years. It has significant efficacy in the treatment of acute leukemia and non-Hodgkin's lymphoma and is considered to be one of the most promising treatments for cancer.
  • Chimeric antigen receptors (CAR) T cells (CAR-T) are genetically modified for the patient's own T cells and are successful in treating blood cancer, but using CAR-T to treat solid tumors ( It is composed of heterogeneous cell populations with different surface molecules that do not achieve the desired therapeutic effect.
  • CN105505869A discloses a chimeric receptor T cell targeting tumor stem cells, which has two to three independent antigen receptors, each of which is composed of a different tumor stem cell specific marker.
  • the antigen binding portion of the antibody is composed of a combination of different functional proteins.
  • This chimeric receptor T cell activates T cell anti-tumor effects only after 2-3 chimeric antigen receptors recognize the antigen, and this method improves the specificity but the tumor cells that hide the antigen to some extent. Lower specificity.
  • CAR-T genetically modified chimeric antigen receptor T cell
  • the present invention provides a CAR chimeric antigen receptor, a potentiating CAR-immunoblast, and a preparation method thereof.
  • the invention provides a gene encoding a CAR chimeric antigen receptor, comprising an extracellular domain capable of binding an antigen, a signaling domain, an intracellular immunostimulatory molecule, an internal ribosome entry site IRES and a HAC-HSA The coding gene.
  • the extracellular domain comprises the D2 domain of the Slit2 protein; referred to as Slit2D2, the coding gene thereof has the nucleotide sequence shown in SEQ ID No: 1.
  • the coding gene of the HAC has a nucleotide sequence as shown in SEQ ID No: 2;
  • the signaling domain is selected from the group consisting of CD28, CD3 epsilon, CD45, CD4, CD5, CD8, CD9, CD16, CD22, CD33, CD37, CD134, CD137, ICOS, CD154 hinge region, transmembrane region and intracellular region One or more of the zone domains.
  • the signaling domain is selected from the Hinge region, the transmembrane region and the intracellular region of CD8, and more preferably, the CD8 comprises a Hinge region and a transmembrane region of CD8;
  • the intracellular immunostimulatory molecule is selected from the group consisting of CD3 ⁇ , CD3 ⁇ , CD3 ⁇ , CD3 ⁇ , CD5, CD22, CD79a, CD79b, CD66d, CD2, CD4, CD5, CD28, CD134, CD137, ICOS, CD154, 4-1BB And one or more of the OX40 intracellular domains;
  • the intracellular immunocostimulatory molecule comprises a 4-1BB and a CD3 sputum intracellular domain;
  • the above coding gene further comprises a signal peptide Signal peptide1 (SP1) encoding gene represented by SEQ ID No: 3;
  • SP1 signal peptide Signal peptide1
  • the above coding gene further comprises a nucleotide coding sequence as shown in SEQ ID No: 4;
  • the above coding gene further comprises a Linker coding gene having a nucleotide sequence as shown in SEQ ID No: 5;
  • the above coding gene further comprises a signal peptide Signal peptide 2 (SP2) encoding gene represented by SEQ ID No: 6;
  • SP2 signal peptide Signal peptide 2
  • the above coding gene comprises a SP1-Flag-Linker-Slit2D2-CD8-4-1BB-CD3 ⁇ fusion gene having a nucleotide sequence as shown in SEQ ID No: 7.
  • the above coding gene comprises a SP2-HAC-HSA fusion gene having a nucleotide sequence as shown in SEQ ID No: 8.
  • the gene encoding the CAR chimeric antigen receptor is SP1-Flag-Linker-Slit2D2-CD8-4-1BB-CD3 ⁇ -IRES-SP2-HAC-HSA encoding gene, the core of IRES
  • the nucleotide sequence is shown in SEQ ID No: 9.
  • Another aspect of the present invention provides a recombinant vector and a recombinant strain loaded with the above-mentioned coding gene;
  • the recombinant vector is selected from the group consisting of a lentivirus, a retrovirus, an adenovirus, an adeno-associated virus or a plasmid.
  • Another aspect of the present invention provides a use of the above-described coding gene, a recombinant vector loaded with the above-mentioned coding gene, and a recombinant strain for modifying immune cells and preparing antitumor drugs;
  • the immune cells are selected from the group consisting of: T cells, NK cells such as NK92.
  • Another aspect of the present invention provides a booster CAR-immunoblast comprising the above-described coding gene
  • the enhanced CAR-immunoblast is a booster CAR-T cell or a booster CAR-NK cell such as a booster CAR-NK92 cell.
  • Another aspect of the present invention also provides the use of the above-described enhanced CAR-immune cells for the preparation of an antitumor drug.
  • the present invention provides a CAR chimeric antigen receptor which is obtained by transcriptional expression of the above coding gene, comprising: an extracellular domain capable of binding antigen, a transmembrane domain, an intracellular immunostimulatory molecule, an internal ribosome Enter the sites IRES and HAC-HSA.
  • the extracellular domain comprises the D2 domain of the Slit2 protein.
  • the signaling domain is selected from the group consisting of a hinge region and a transmembrane region of CD28, CD3 epsilon, CD45, CD4, CD5, CD8, CD9, CD16, CD22, CD33, CD37, CD134, CD137, ICOS, CD154 And one or more of the intracellular regions.
  • the signal transduction domain is selected from CD8 hinge region, transmembrane region and intracellular region, more preferably, is the Hinge region CD8 CD8 and CD8 transmembrane domain (TM).
  • the intracellular immunostimulatory molecule is selected from the group consisting of CD3 ⁇ , CD3 ⁇ , CD3 ⁇ , CD3 ⁇ , CD5, CD22, CD79a, CD79b, CD66d, CD2, CD4, CD5, CD28, CD134, CD137, ICOS, CD154, 4-1BB And one or more of the OX40 intracellular domains.
  • the intracellular immune costimulatory molecule comprises a 4-1BB and a CD3 sputum intracellular domain.
  • the HAC in the HAC-HSA of the present invention is a PD-1 protein with high-affinity consensus (HAC), which can block the wild-type PD-1 protein and the PD-L ligand in vivo and in vitro.
  • HAC high-affinity consensus
  • the HAC lacks a transmembrane domain relative to the wild-type PD-1 protein and has one or several amino acid residue changes, while at the same time increasing the affinity for the PD-L1 ligand;
  • amino acid residue is altered and can be located in the PD-1 and PD-L1 binding domains, and/or,
  • Amino acid residue changes can be located in the immunoglobulin domain of PD-1.
  • the HAC comprises an amino acid sequence selected from the group consisting of 85% or higher, 90% or higher, 95% or higher, 98%, 99% relative to the wild-type PD-1 protein polypeptide identity. Or higher, 99.2% or higher.
  • the HAC comprises an amino acid sequence having an identity of 85% or greater, 90% or greater, 95% or greater relative to the immunoglobulin domain of the wild-type PD-1 protein polypeptide. , 98%, 99% or higher, 99.2% or higher, 99.8% or higher, 99.9% or higher, or 100%.
  • the HAC comprises an amino acid sequence having an amino acid sequence identity of 85% or greater, 90% or greater, relative to the original mock PD-1 polypeptide as set forth in SEQ ID No: 6. % or higher, 98%, 99% or higher, 99.2% or higher, 99.8% or higher, 99.9% or higher, or 100%.
  • the HAC comprises a mutation of one amino acid relative to a wild-type PD-1 protein polypeptide, and the mutation of the amino acid increases the affinity of the HAC for PD-L1;
  • One or more of the amino acid changes, two or more, three or more, four or more, five or more, six or more, seven or more, eight or Multiple, 9 or more, 10 or more, 11 or more, 12 or more, 13 or more, 14 or more, 15 or more, 16 or more , 17 or more, 18 or more, 19 or more, 20 or more, etc.
  • the amino acid residue is altered, the site of which is selected from the group consisting of V39, L40, N41, Y43, R44, M45 in the wild type PD-1 fragment shown in SEQ ID No: 6.
  • the amino acid changes include one or more amino acid changes; the plurality of amino acids are changed to two or more, three or more, 4 or more, 5 or more, 6 or more, 7 or more, 8 or more, 9 or more, 10 or more, 11 or more, 12 Or multiple, 13 or more, 14 or more, 15 or more, 16 or more, 17 or more, 18 or more.
  • the amino acid residue alteration can be located in the PD-1 and PD-L1 binding domains, the amino acid alteration site being located in the PD-1 fragment as set forth in SEQ ID No: Medium, selected from V39, N41, Y43, M45, S48, N49, Q50, T51, D52, K53, A56, Q63, G65, Q66, L97, S102, L103, A104, P105, K106, A107; or other wild One or more of the amino acids at the corresponding positions of the PD-1 protein; the amino acid changes include one or more amino acid changes; the plurality of amino acids are changed to two or more, three or more, 4 or more, 5 or more, 6 or more, 7 or more, 8 or more, 9 or more, 10 or more, 11 or more, 12 Or more than 13 or more, 14 or more, 15 or more.
  • SEQ ID No: Medium selected from V39, N41, Y43, M45, S48, N49, Q50, T51, D52, K53
  • the amino acid residue is altered, the site of which is located in the PD-1 fragment set forth in SEQ ID No: 6, selected from: (a) V39, N41, Y43, M45, S48, N49, Q50, K53, A56, Q63, G65, Q66, L97, A100, S102, L103, A104, K106 And A107; or other amino acid corresponding to the wild-type PD-1 protein; (b) V39, N41, Y43, M45, S48, Q50, T51, D52F, K53, A56, Q63, G65, Q66, L97, S102, L103, A104, K106 and A107; or, other wild type PD-1 protein corresponding amino acids (c) V39, L40, N41, Y43, R44, M45, N49, K53, M83, L97, A100 and A107; Amino acids at corresponding positions of other wild-type PD-1 proteins; (d) V39, L40,
  • the amino acid residue is altered, the site of which is located in the PD-1 fragment set forth in SEQ ID No: 6, selected from: (1) V39H or V39R; (2) L40V or L40I (3) N41I or N41V; (4) Y43F or Y43H; (5) R44Y or R44L; (6) M45Q, M45E, M45L or M45D; (7) S48D, S48L, S48N, S48G or S48V; (8) N49C , N49G, N49Y or N49S; (9) Q50K, Q50E or Q50H; (10) T51V, T51L or T51A; (11) D52F, D52R, D52Y or D52V; (12) K53T or K53L; (13) A56S or A56L; (14) Q63T; Q63I, Q63E, Q63L or Q63P; (15) G65N; G65R, G65I, G65L, G65F or G65
  • the amino acid residue is altered, the site of which is located in the PD-1 fragment set forth in SEQ ID No: 6, selected from: (a) ⁇ V39H or V39R ⁇ , ⁇ N41I or N41V ⁇ , ⁇ Y43F,Y43H ⁇ , ⁇ M45Q,M45E,M45L or M45D ⁇ , ⁇ S48D,S48L,S48N,S48G or S48V ⁇ , ⁇ N49C,N49G,N49Y or N49S ⁇ , ⁇ Q50K,Q50E or Q50H ⁇ , ⁇ K53T Or K53L ⁇ , ⁇ A56S or A56L ⁇ , ⁇ Q63T, Q63I, Q63E, Q63L or Q63P ⁇ , ⁇ G65N, G65R, G65I, G65L, G65F or G65V ⁇ , ⁇ L97Y, L97V or L97I ⁇ , ⁇ S102T or S102A ⁇ , ⁇ L103I, L103Y or L103F ⁇
  • the amino acid residue is altered, the site of which is located in the PD-1 fragment set forth in SEQ ID No: 6, selected from: (a) V39R, N41V, Y43H, M45E, S48G, Q50E, K53T, A56S, Q63T, G65L, Q66P, L97V, S102A, L103F, A104H, K106V and A107I; or, amino acids corresponding to other wild-type PD-1 proteins;
  • the PD-1 protein HAC having a high affinity consensus may be a post-transcriptional modification protein; the modifications include glycosylation, PEG modification, and the like.
  • amino acid residue is changed to N41I or N41V.
  • the CAR chimeric antigen receptor comprises a SP1-Flag-Linker-Slit2D2-CD8-4-1BB-CD3 ⁇ element having:
  • amino acid sequence derived therefrom which is 1) substituted and/or deleted and/or added by one or several amino acid residues and having the same function.
  • the CAR chimeric antigen receptor comprises an SP2-HAC-HSA element having:
  • the substitution and/or deletion and/or addition of the one or several amino acid residues is a substitution and/or deletion and/or addition of no more than 10 amino acid residues.
  • the "-" linkage of the amino acid sequence of the present invention is such that the N-terminus of one fragment is directly linked to the C-terminus of another fragment without any linker peptide in between, for example, HAC-HSA, and the HAC domain passes through the C-terminus and the HSA domain.
  • the N-terminus is directly linked, or the HAC domain is directly linked by its N-terminus to the C-terminus of the HSA domain, ie, the HAC domain is directly linked to the HSA domain without any linker peptide in between.
  • Another aspect of the present invention provides a method for preparing a boosted CAR-immunized cell.
  • the synthetic coding gene of the present invention can easily prepare a base sequence encoding CAR from a predetermined CAR amino acid sequence by a conventional method, and the NCBI of the amino acid sequence.
  • the Ref Seq ID or GenBenk accession number gives the base sequence encoding the amino acid sequence, and the nucleic acid of the present invention can be prepared using standard molecular biology and/or chemical procedures.
  • the method for preparing the enhanced CAR-immune cell of the present invention comprises the following steps:
  • Construction of vector construction of a vector capable of expressing the above CAR receptor
  • packaging of virus transfected with immune cells packaging the virus using the vector constructed in step (1) to obtain a packaged virus
  • the T cells cultured in the step (3) are transfected and expanded and cultured using the packaged virus in the step (2) to obtain a chimeric antigen receptor T cell abbreviation. CAR-immune cells.
  • the chimeric antigen receptor immune cell is a gene encoding a chimeric antigen receptor of the present invention introduced into an immune cell.
  • the expression vector may use a viral vector such as a retroviral vector (including an oncogenic retroviral vector, a lentiviral vector, and a pseudotype vector), an adenovirus vector, or a vaccinia virus vector that lacks replication ability and is unable to self-replicate in a transfected cell. Or HSV vector, etc.;
  • a retroviral vector including an oncogenic retroviral vector, a lentiviral vector, and a pseudotype vector
  • an adenovirus vector or a vaccinia virus vector that lacks replication ability and is unable to self-replicate in a transfected cell.
  • HSV vector etc.
  • the immune cells in the present invention are derived from immune cells of human peripheral blood, more preferably from: T cells, NK cells such as NK92; more preferably, various types of commercially available antibodies can be selected according to retrovirus in the present invention.
  • the packaging plasmid can be used to package a retroviral vector, and retrovirus particles can also be prepared using 293 cells or 293T cells with high transfection efficiency.
  • the construction of the vector described in the step (1) comprises amplification of the extracellular domain Slit2D2, a transmembrane domain, an intracellular immunostimulatory molecule, an internal ribosome entry site, an IRES and a HAC-HSA gene, and a restriction enzyme digestion. Connect and convert.
  • the method for preparing the enhanced CAR-T cell comprises the following steps:
  • step (3) using the packaged lentivirus in step (2), the T cells cultured in step (3) are transfected and expanded to make T cells express Slit2D2-CD8TM- 4-1BB-CD3 ⁇ -IRES-HAC-HSA.
  • the invention combines the CAR technology and the PD-1 antibody immunological checkpoint treatment method, and prepares the enhanced CAR-immunized cells by adding the secretory HAC-HSA fusion gene to the conventional CAR-immunized cell expression vector, wherein the HAC-HSA
  • the expressed PD-1 protein has a higher affinity with PDL-1.
  • the fusion of the HSA protein prolongs the half-life of the protein.
  • the enhanced CAR-immunized cells of the present invention have the traditional CAR-immunized cell targeted killing ability, and can secrete PD-1 fusion protein and block PDL- 1 Inhibitory signal, enhances CAR-immuno killing activity, and activates tumor-infiltrating immune cells.
  • Example 1 is a schematic diagram showing the construction of the Slit2D2-CAR gene provided in Example 1 of the present invention
  • FIG. 2 is a schematic diagram showing the construction of the Slit2D2-CD8TM-4-1BB-CD3 ⁇ -IRES-HAC-HSA gene provided in Example 1 of the present invention
  • FIG. 3 is a schematic diagram of a pRRSLIN-slit2D2 CAR&HAC-HSA lentiviral expression vector provided in Example 1 of the present invention
  • Example 4 is a flow chart showing the effect of flow infusion of CAR-T cells according to Example 4 of the present invention.
  • Figure 5 is a diagram showing the flow-through effect of CAR-NK92 cells provided in Example 4 of the present invention.
  • Figure 6 is a graph showing the results of in vitro killing experiments of enhanced CAR-T (slit2D2 CAR&HAC-HSA) cells and common CAR-T (slit2D2 CAR) cells under different target-target conditions according to Example 6 of the present invention;
  • the target cell is H1299
  • the target cell in B is SMMC7721.
  • the second domain of Slit2, Slit2D2 was constructed according to the known Slit2 sequence [GenBank: EAW92793.1]. The gene sequence is shown in SEQ ID NO: 1, and the known GenBank database is searched. Human CD8 Hinge region and CD8 TM transmembrane region gene sequence, human 4-1BB intracellular region gene sequence, CD3 intracellular region, IRES internal ribosome entry site, resulting in Slit2D2-CAR (SP1-Flag-Linker-Slit2D2- The CD8-4-1BB-CD3 ⁇ ) gene is shown in SEQ ID NO: 7, and its tandem schematic diagram is shown in Figure 1; the HAC gene fragment is synthesized, the nucleotide sequence of which is shown in SEQ ID NO: 2, and in its C The HSA gene was introduced at the end to obtain the HAC-HSA fusion gene (SP2-HAC-HSA) as shown in SEQ ID NO: 8.
  • the gene sequence of Slit2D2-CD8-4-1BB-CD3 ⁇ -IRES-HAC-HSA was transformed into the PRRSLIN vector by double restriction enzyme ligation, and the upstream of the gene was the EP-1 ⁇ promoter.
  • the vector was transformed into Stbl3 Escherichia coli strain, then transferred to a solid medium containing ampicillin for propagation, screened, positive clones were obtained, plasmids were extracted, and clones were identified by enzyme digestion.
  • the vector was successfully constructed by sequencing, and pRRSLIN-Slit2D2 was obtained slowly. See Figure 3 for a schematic representation of the construction of the viral expression vector and lentiviral expression vector.
  • Solution A 6.25 mL 2 x HEPES buffer buffer (the amount of packaging with 5 large dishes is the best).
  • Solution B A mixture of the following plasmids was separately added: 112.5 ⁇ g pRRSLIN-Slit2D2-CAR-IRES-HAC-HSA (target plasmid); 39.5 ⁇ g pMD2.G (VSV-G envelop); 73 ⁇ g pCMVR8.74 (gag, pol, tat, Rev); 625 ⁇ L 2M calcium ion solution. Total volume of solution B: 6.25 mL.
  • the filtered lentivirus-containing supernatant was transferred to a centrifuge tube, carefully layered with 20% sucrose (8 mL of sucrose per 8 mL of supernatant) at the bottom of the tube, and the tube was equilibrated with PBS at 25,000 rpm ( 82,700g), centrifuge at 2 °C for 2h; carefully remove the centrifuge tube, pour off the supernatant, invert the centrifuge tube to remove residual liquid; add 100 ⁇ L PBS, seal the centrifuge tube, place at 4 ° C for 2h, gently vortex every 20min
  • the virus supernatant was collected by centrifugation at 500 g for 1 min (25 ° C); after cooling on ice, it was
  • PBMC peripheral blood mononuclear cells
  • V-VIVO15 added autologous AB (FBS) concentration of 5%, interleukin-2 (IL-2) concentration of 40 ng / mL, and the isolated PBMC was diluted to 2 ⁇ with the culture medium. 10 6 /mL, 50 ⁇ L flow detection of the purity of T cells in PBMC.
  • FBS autologous AB
  • IL-2 interleukin-2
  • CAR-NK92 cells were prepared by referring to the experimental procedure of Example 3.
  • Example 5 Flow cytometry analysis of CAR-T cells and CAR-NK92 cells
  • Flow cytometry measures APC fluorescence signal. If compared with control T cells or NK cells, the APC fluorescence signal of CAR cells is enhanced and the surface CAR cells are successfully constructed.
  • a and C are the control group: T cells that do not infect the virus; APC coupled with the antibody detecting the CAR molecule does not detect the expression of the CAR molecule; B: T cells transfected with the slit2D2 CAR virus, the flow Detection, cells successfully transfected slit2D2 CAR molecules; D map: T cells transfected with slit2D2 & HAC-HSA CAR-virus, cells were successfully transfected into slit2D2 & HAC-HSA CAR molecules by flow cytometry. Panels B and D illustrate the successful preparation of the corresponding CAR-T cells, respectively.
  • a and C are the control group: NK cells that do not infect the virus; APC-conjugated antibodies for detecting CAR molecules do not detect CAR molecule expression;
  • Panel B NK cells transfected with slit2D2 CAR virus, flow through In the detection, cells successfully transfected with slit2D2 CAR molecules;
  • D images were transfected into s cells of slit2D2 & HAC-HSA CAR-T virus, and cells were successfully transfected into slit2D2 & HAC-HSA CAR molecules by flow cytometry.
  • Panels B and D illustrate the successful preparation of the corresponding CAR-NK cells, respectively.
  • the killing effect of CAR-T cells on tumor cells was detected by LDH release method, and LDH release was detected by ELISA.
  • target cells to a 96-well cell culture plate and add 100 ⁇ L per well. Three wells were used as effector cells (CAR-T cells) to naturally release control wells, and no target cells were added, and only 100 ⁇ L of the culture solution was added.
  • CAR-T cells effector cells
  • Killing rate experimental group LDH (OD) / maximum LDH release group (OD).
  • the cytokine secretion was measured by CBA kit, and the proliferation of each group of CAR-T cells was calculated, and the ratio of CD8-positive T cells in the proliferating T cells was confirmed by staining with CD3 and CD8 antibodies.

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Abstract

L'invention concerne un procédé de préparation et d'utilisation de cellules CAR-T Slit2 améliorées et de cellules CAR-NK. Les cellules CAR-T améliorées et les cellules CAR-NK sont respectivement des cellules T et des cellules NK contenant un récepteur antigénique chimérique CAR amélioré. Le récepteur d'antigène chimérique CAR amélioré comprend un domaine extracellulaire capable de se lier à un antigène, un domaine transmembranaire, une molécule costimulatrice immunitaire intracellulaire, un site interne d'entrée de ribosome IRES, et une série HAC-HAS. Le domaine extracellulaire comprend le domaine D2 de la protéine Slit-2. Les cellules CAR-T améliorées et les cellules CAR-NK améliorées peuvent bloquer le signal inhibiteur du ligand 1 (PDL -1) de la mort cellulaire programmée, améliorent l'activité destructrice de cellules immunitaires CAR, et activent les cellules immunitaires infiltrant les tumeurs. Les cellules immunitaires CAR améliorées peuvent être utilisées comme médicament cellulaire pour le traitement de maladies tumorales, de sorte que les cellules immunitaires modifiées peuvent reconnaître et tuer de manière spécifique des tumeurs et avoir une activité de destruction de tumeur élevée accrue.
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