Link to article: http://www.nejm.org/doi/full/10.1056/NEJMoa1103849#t=article 1.

Question

Link to article: http://www.nejm.org/doi/full/10.1056/NEJMoa1103849#t=article

1. The research article states that CAR T cells recognize target cells in a HLAunrestricted
manner. What does this mean and how are CAR T cells able to
accomplish this?
2. Regarding the CD19/CD5 plots shown in Figure 3C, describe the expression
of these two proteins on cells localized to the UL, UR, LL and LR quadrants.
What is the major cell type localized in each quadrant? You need 4 answers
here, one for each quadrant.

Explanation / Answer

1. Chimeric Antigen Receptor (CAR) are capable of rapid growth and cytotoxicity in vivo indicates the need for caution in the design of clinical trails when CAR with new specifications are tested.

So that readily available chimeric antigen receptors can be constructed for tumours with wide variety of histological features.

The development of tumour lysis syndrome is delayed and response after treatment with T-cells in 3 weeks which is genetically modified to target CD19 through transduction.

High levels of genetically modified cells are present in bone marrow after infusion which was demonstrated by temporal release of cytokines that coincided with peak infiltration of CAR T cells.

2. On day 31 after infusion, CD5 + T cells are present

UL - In upper CD5 FITC is dominant and in lower CD19 is dominant

UR - CD5 FITC and immunoglobulin kappa APC

LL - CD19 and subsets of immunoglobulin kappa APC and immunoglobulin lamba PE

LR - CD19 and subsets of LL

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