小柯机器人

研究发现抗CD19 CAR T细胞治疗后反应和毒性的肠道微生物组相关因素
2022-03-20 14:47

美国宾夕法尼亚大学Marco Ruella等研究人员合作发现抗CD19嵌合抗原受体(CAR)T细胞治疗后反应和毒性的肠道微生物组相关因素。2022年3月14日,《自然—医学》杂志在线发表了这项成果。

据研究人员介绍,抗CD19 CAR T细胞疗法在高危血液病恶性肿瘤患者中带来了前所未有的反应。然而,高达60%的患者仍然经历疾病复发,高达80%的患者经历CAR介导的毒性,如细胞因子释放综合征或免疫效应细胞相关的神经毒性综合征。
 
研究人员在一项针对B细胞淋巴瘤和白血病患者的多中心研究中调查了肠道微生物组对这些结果的作用。研究人员在一个回顾性队列(n=228)中发现,在治疗前4周内接触抗生素,特别是哌拉西林/他唑巴坦、美罗培南和亚胺培南/西司他丁(P-I-M),与生存率下降和神经毒性增加有关。在一个前瞻性的CAR T细胞接受者队列(n=48)的粪便样本中,与健康对照组相比,粪便微生物组在基线上有所改变。通过16S核糖体RNA和元基因组猎枪测序对粪便样本进行分析,结果发现临床结果与特定细菌分类群和代谢途径的差异有关。通过对16S测序数据的非目标和假设驱动的分析,研究人员确定了梭菌类中与第100天完全反应有关的物种。研究人员认为,肠道微生物组的变化与B细胞恶性肿瘤患者接受抗CD19 CAR T细胞治疗后的临床结果有关。
 
附:英文原文

Title: Gut microbiome correlates of response and toxicity following anti-CD19 CAR T cell therapy

Author: Smith, Melody, Dai, Anqi, Ghilardi, Guido, Amelsberg, Kimberly V., Devlin, Sean M., Pajarillo, Raymone, Slingerland, John B., Beghi, Silvia, Herrera, Pamela S., Giardina, Paul, Clurman, Annelie, Dwomoh, Emmanuel, Armijo, Gabriel, Gomes, Antonio L. C., Littmann, Eric R., Schluter, Jonas, Fontana, Emily, Taur, Ying, Park, Jae H., Palomba, Maria Lia, Halton, Elizabeth, Ruiz, Josel, Jain, Tania, Pennisi, Martina, Afuye, Aishat Olaide, Perales, Miguel-Angel, Freyer, Craig W., Garfall, Alfred, Gier, Shannon, Nasta, Sunita, Landsburg, Daniel, Gerson, James, Svoboda, Jakub, Cross, Justin, Chong, Elise A., Giralt, Sergio, Gill, Saar I., Riviere, Isabelle, Porter, David L., Schuster, Stephen J., Sadelain, Michel, Frey, Noelle, Brentjens, Renier J., June, Carl H., Pamer, Eric G., Peled, Jonathan U., Facciabene, Andrea, van den Brink, Marcel R. M., Ruella, Marco

Issue&Volume: 2022-03-14

Abstract: Anti-CD19 chimeric antigen receptor (CAR) T cell therapy has led to unprecedented responses in patients with high-risk hematologic malignancies. However, up to 60% of patients still experience disease relapse and up to 80% of patients experience CAR-mediated toxicities, such as cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. We investigated the role of the intestinal microbiome on these outcomes in a multicenter study of patients with B cell lymphoma and leukemia. We found in a retrospective cohort (n=228) that exposure to antibiotics, in particular piperacillin/tazobactam, meropenem and imipenem/cilastatin (P-I-M), in the 4 weeks before therapy was associated with worse survival and increased neurotoxicity. In stool samples from a prospective cohort of CAR T cell recipients (n=48), the fecal microbiome was altered at baseline compared to healthy controls. Stool sample profiling by 16S ribosomal RNA and metagenomic shotgun sequencing revealed that clinical outcomes were associated with differences in specific bacterial taxa and metabolic pathways. Through both untargeted and hypothesis-driven analysis of 16S sequencing data, we identified species within the class Clostridia that were associated with day 100 complete response. We concluded that changes in the intestinal microbiome are associated with clinical outcomes after anti-CD19 CAR T cell therapy in patients with B cell malignancies.

DOI: 10.1038/s41591-022-01702-9

Source: https://www.nature.com/articles/s41591-022-01702-9

Nature Medicine:《自然—医学》,创刊于1995年。隶属于施普林格·自然出版集团,最新IF:87.241
官方网址:https://www.nature.com/nm/
投稿链接:https://mts-nmed.nature.com/cgi-bin/main.plex


本期文章:《自然—医学》:Online/在线发表

分享到:

0