Xiao and Zhu et al. engineered an inhalable small extracellular vesicle (sEV) loaded with mesothelin-specific CAR mRNA (CARmRNA@aCD206 sEVs) to generate CAR-Ms in situ. in a lung metastasis mouse model, inhaled CARmRNA@aCD206 sEVs accumulated in the lungs, selectively delivered CAR mRNA into macrophages via CD206 recognition, and polarized macrophages to an immunostimulatory phenotype with enhanced phagocytosis. The in situ-generated CAR-Ms showed enhanced pro-inflammatory cytokine secretion and antitumor cytotoxicity, reduced tumor burden, induced long-term immune memory, prevented recurrence, and prolonged overall survival.

Contributed by Shishir Pant

ABSTRACT: Cancer metastasis and recurrence remain the leading causes of cancer-related mortality, and lung is a major metastatic anatomical location. Chimeric antigen receptor macrophages (CAR-M) represent promising candidates for cancer therapy owing to their superior tumour-infiltrating and antigen-specific phagocytotic abilities, and to being professional antigen presenting cells. However, broader applications of CAR-Ms face challenges such as complex manufacturing processes and predominant accumulation in the liver following intravenous administration. Here we present an inhalable engineered small extracellular vesicle (sEV), which contains mesothelin-specific CAR messenger RNA (CAR(mRNA)@aCD206 sEVs) for in situ generation of CAR-Ms. The sEVs are surface-integrated with anti-CD206 single-chain variable fragments (scFv) to target CD206-expressing, immunosuppressive (M2 phenotype) macrophages. The results in mouse models suggest that inhaled CAR(mRNA)@aCD206 sEVs could accumulate in lung tissue and deliver CAR mRNA specifically to macrophages, facilitating in situ CAR-M production. In a lung metastasis model, inhaled CAR(mRNA)@aCD206 sEVs effectively inhibit tumor growth and prime long-term memory immunity to prevent tumour recurrence. Collectively, our engineered sEV delivery platform demonstrates capability to selectively deliver CAR mRNA to macrophages in lung tissue, providing a promising immunotherapy strategy to effectively combat lung metastasis and recurrence via generation of CAR-Ms in situ.

Author Info: (1) Center for Infection and Immunity, Guangdong Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China

Author Info: (1) Center for Infection and Immunity, Guangdong Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China. (2) Center for Infection and Immunity, Guangdong Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China. (3) Kingcell Regenerative Medicine (Guangdong) Co., Zhuhai, Guangdong, China. (4) Center for Infection and Immunity, Guangdong Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China. huangxi6@mail.sysu.edu.cn.