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. 2024 Apr 8;12(4):e008429. doi: 10.1136/jitc-2023-008429

Figure 4.

Figure 4

PD-1 inhibition promotes the memory phenotype and reduces the exhaustion of BCMA CAR-T cells. (A) Schematic diagram of the CAR-T cell cytotoxicity assay after long-term repetitive antigen stimulation. (B) CAR expression was determined by flow cytometry in PD-1KD BCMA CAR-T cells (upper) and BCMA CAR-T cells (lower) after fourth repetitive stimulation (d13). Representative (B) and summarized (E) data from three representative healthy donors are shown. (C) Annexin V and PI-staining of PD-1KD BCMA CAR+T and BCMA CAR+T cells after four repetitive stimulations (d13). Representative (C) and summarized (F) data from three representative healthy donors are shown. (D) Representative differentiation statuses of PD-1KD BCMA CAR-T cells (upper) and BCMA CAR-T cells (lower) cells were determined by flow cytometry using the surface markers CD45RA and CD62L after four repetitive stimulations (d13). (G, H) Ratios of central memory (Tcm; CD45RA−CD62L+) and effector memory (Tem; CD45RA−CD62L−) cells were compared for PD-1KD BCMA CAR-T and BCMA CAR-T cells. (I) GSEA of central memory genes. The central memory genes are shown in online supplemental table 3. The genes from the left to the right of the rank-ordered list are enriched in PD-1KD BCMA CAR-T cells and BCMA CAR-T cells. (J) GSEA of effector versus exhausted up genes. Effector versus exhausted upgenes are shown in online supplemental table 4. The genes from the left to the right of the rank-ordered list are enriched in PD-1KD BCMA CAR-T cells and BCMA CAR-T cells. (K, L) Volcano plots of genes differentially expressed between PD-1KD BCMA CAR+T cells and BCMA CAR+T cells sorted after one antigen stimulation (d1) or after four repetitive stimulations (d13). Significantly differentially expressed genes associated with the memory phenotype are highlighted with an orange circle. (M) Heatmap of normalized RNA-seq reads for exhaustion-related genes differentially expressed between PD-1KD BCMA CAR+ and BCMA CAR+T cells after four repetitive stimulations (d13). The results are from two representative healthy donors with two duplicates. BCMA, B cell maturation antigen; GSEA, gene set enrichment analysis; HD, heathy donor; NES, normalized enrichment score; FDR, false discovery rate.