Xiao et al. tested how CAR T cell activation is affected by the relative lengths of the CAR construct, the antigen target, and the membrane phosphatase CD45. Reducing the length of the CAR extracellular domain (by removing Ig domains) enhanced exclusion of CD45 from the CAR synapse, increased CAR T cell activation (intracellular phosphorylation, cytotoxicity, and cytokine production), and better restrained tumor growth in vivo. Decreasing antigen length or increasing the size of CD45 (mAb binding or a longer isoform) had similar effects, indicating that CAR T cell activation and antitumor efficacy are enhanced by exclusion of CD45 from the CAR synapse, and can be physically tuned.

Contributed by Alex Najibi

ABSTRACT: As the targets of chimeric antigen receptor (CAR)-T cells expand to a variety of cancers, autoimmune diseases, viral infections, and fibrosis, there is an increasing demand for identifying new antigens and designing new CARs that can be effectively activated. However, the rational selection of antigens and the design of CARs are limited by a lack of knowledge regarding the molecular mechanism by which CARs are activated by antigens. Here, we present data supporting a "size exclusion" model explaining how antigen signals are transmitted across the plasma membrane to activate the intracellular domains of CARs. In this model, antigen engagement with CAR results in a narrow intermembrane space that physically excludes CD45, a bulky phosphatase, out of the CAR zone, thus favoring CAR phosphorylation by kinases, which further triggers downstream pathways leading to T cell activation. Aligned with this model, increasing the size of CAR extracellular domains diminished CAR-T activation both in vitro and in a mouse lymphoma model; membrane-proximal epitopes activated CAR-Ts better than membrane-distal epitopes. Moreover, increasing the size of CD45 by antibody conjugation enhanced the activation of CARs that recognize membrane-distal epitopes. Consistently, CAR-Ts expressing CD45RABC, the larger isoform, were activated to a higher level than those expressing a smaller isoform CD45RO. Together, our work revealed that CAR-T activation depends on the size difference between the CAR-antigen pair and CD45; the size of CAR, antigen, and CD45 can thus be targets for tuning CAR-T activation.

Author Info: (1) Department of Cell Biology, Yale School of Medicine, New Haven, CT 06520, USA. Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence, Rutgers Cancer

Author Info: (1) Department of Cell Biology, Yale School of Medicine, New Haven, CT 06520, USA. Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA. Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08854, USA. (2) Department of Cell Biology, Yale School of Medicine, New Haven, CT 06520, USA. (3) Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA. (4) Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA. Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08854, USA. (5) Duncan and Nancy MacMillan Cancer Immunology and Metabolism Center of Excellence, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA. Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08854, USA. (6) Department of Cell Biology, Yale School of Medicine, New Haven, CT 06520, USA. Yale Cancer Center, Yale University, New Haven, CT 06520, USA.