This work was supported by grants from the National Key Research and Development Program of China (2016YFC1303402), the National Megaproject on Key Infectious Diseases (2017ZX10202102, 2017ZX10304402-002-007), and the General Program of Shanghai Municipal Health Commission (201740194).

In this study, HER2-BBz-ODD, a hypoxia-sensitive CAR targeting HER2 (Gene ID: 2064) was compared with its regular counterpart, HER2-BBz. The schematics of the two CARs are illustrated in Figure 1A, which shows that HER2-BBz-ODD is derived from HER2-BBz by adding the ODD sequence to the C-terminal of CD3&#958;. The construction of lentiviral vectors expressing the two CARs and the generation of the corresponding lentivirus by 293T cell transfection has been previously described<sup class="xre...

Functional Validation of Hypoxia-Sensitive CAR-T Cells for Selective Tumors

<ol>
	<li>Boardman, A. P., Salles, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CAR+T-cell+therapy+in+large+B+cell+lymphoma.">CAR T-cell therapy in large B cell lymphoma.</a> Hematol Oncol. 41 (S1), 112-118 (2023).</li><li>Chen, Y. -. J., Abila, B., Mostafa Kamel, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CAR-T:+What+is+next.">CAR-T: What is next.</a> Cancers. 15 (3), 663 (2023).</li><li>Barsan, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tisagenlecleucel+utilisation+and+outcomes+across+refractory,+first+relapse+and+multiply+relapsed+B-cell+acute+lymphoblastic+leukemia:+A+retrospective+analysis+of+real-world+patterns.">Tisagenlecleucel utilisation and outcomes across refractory, first relapse and multiply relapsed B-cell acute lymphoblastic leukemia: A retrospective analysis of real-world patterns.</a> eClinicalMedicine. 65, 102268 (2023).</li><li>Liu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oncolytic+herpes+simplex+virus+delivery+of+dual+CAR+targets+of+CD19+and+BCMA+as+well+as+immunomodulators+to+enhance+therapeutic+efficacy+in+solid+tumors+combined+with+CAR-T+cell+therapy.">Oncolytic herpes simplex virus delivery of dual CAR targets of CD19 and BCMA as well as immunomodulators to enhance therapeutic efficacy in solid tumors combined with CAR-T cell therapy.</a> Front Oncol. 12, 1037934 (2022).</li><li>Liu, C., Qi, T., Milner, J. J., Lu, Y., Cao, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Speed+and+location+both+matter:+Antigen+stimulus+dynamics+controls+CAR-T+cell+response.">Speed and location both matter: Antigen stimulus dynamics controls CAR-T cell response.</a> Front Immunol. 12, 748768 (2021).</li><li>Li, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+the+anti-solid+tumor+efficacy+of+CAR-T+cells+by+inhibiting+adenosine+signaling+pathway.">Improving the anti-solid tumor efficacy of CAR-T cells by inhibiting adenosine signaling pathway.</a> Oncoimmunology. 9 (1), 1824643 (2020).</li><li>Derenzo, C., Gottschalk, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+modification+strategies+to+enhance+CAR+T+cell+persistence+for+patients+with+solid+tumors.">Genetic modification strategies to enhance CAR T cell persistence for patients with solid tumors.</a> Front Immunol. 10, 218 (2019).</li><li>Fu, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Delivery+techniques+for+enhancing+CAR+T+cell+therapy+against+solid+tumors.">Delivery techniques for enhancing CAR T cell therapy against solid tumors.</a> Advanced Functional Materials. 31 (44), 2009489 (2021).</li><li>Johnson, A., Townsend, M., O'Neill, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumor+microenvironment+immunosuppression:+A+roadblock+to+CAR+T-cell+advancement+in+solid+tumors.">Tumor microenvironment immunosuppression: A roadblock to CAR T-cell advancement in solid tumors.</a> Cells. 11 (22), 3626 (2022).</li><li>Liu, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunosuppression+in+tumor+immune+microenvironment+and+its+optimization+from+CAR-T+cell+therapy.">Immunosuppression in tumor immune microenvironment and its optimization from CAR-T cell therapy.</a> Theranostics. 12 (14), 6273-6290 (2022).</li><li>Luo, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulating+tumor+physical+microenvironment+for+fueling+CAR-T+cell+therapy.">Modulating tumor physical microenvironment for fueling CAR-T cell therapy.</a> Adv Drug Deliv Rev. 185, 114301 (2022).</li><li>Martinez, M., Moon, E. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CAR+T+cells+for+solid+tumors:+New+strategies+for+finding,+infiltrating,+and+surviving+in+the+tumor+microenvironment.">CAR T cells for solid tumors: New strategies for finding, infiltrating, and surviving in the tumor microenvironment.</a> Front Immunol. 10, 128 (2019).</li><li>Zhang, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+immunosuppressive+microenvironment+and+immunotherapy+in+human+glioblastoma.">The immunosuppressive microenvironment and immunotherapy in human glioblastoma.</a> Front Immunol. 13, 1003651 (2022).</li><li>Tie, Y., Tang, F., Wei, Y. Q., Wei, X. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunosuppressive+cells+in+cancer:+Mechanisms+and+potential+therapeutic+targets.">Immunosuppressive cells in cancer: Mechanisms and potential therapeutic targets.</a> J Hematol Oncol. 15 (1), 61 (2022).</li><li>Wu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Engineering+CAR+T+cells+for+enhanced+efficacy+and+safety.">Engineering CAR T cells for enhanced efficacy and safety.</a> APL Bioeng. 6 (1), 011502 (2022).</li><li>Al-Haideri, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=cell+combination+therapy:+The+next+revolution+in+cancer+treatment.">cell combination therapy: The next revolution in cancer treatment.</a> Cancer Cell Int. 22 (1), 365 (2022).</li><li>Fuca, G., Reppel, L., Landoni, E., Savoldo, B., Dotti, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Enhancing+chimeric+antigen+receptor+T-cell+efficacy+in+solid+tumors.">Enhancing chimeric antigen receptor T-cell efficacy in solid tumors.</a> Clin Cancer Res. 26 (11), 2444-2451 (2020).</li><li>Neelapu, S. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chimeric+antigen+receptor+T-cell+therapy+-+assessment+and+management+of+toxicities.">Chimeric antigen receptor T-cell therapy - assessment and management of toxicities.</a> Nat Rev Clin Oncol. 15 (1), 47-62 (2018).</li><li>Mi, J., Ye, Q., Min, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Advances+in+nanotechnology+development+to+overcome+current+roadblocks+in+CAR-T+therapy+for+solid+tumors.">Advances in nanotechnology development to overcome current roadblocks in CAR-T therapy for solid tumors.</a> Front Immunol. 13, 849759 (2022).</li><li>Sterner, R. C., Sterner, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CAR-T+cell+therapy:+Current+limitations+and+potential+strategies.">CAR-T cell therapy: Current limitations and potential strategies.</a> Blood Cancer J. 11 (4), 69 (2021).</li><li>Yu, S., Yi, M., Qin, S., Wu, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Next+generation+chimeric+antigen+receptor+T+cells:+Safety+strategies+to+overcome+toxicity.">Next generation chimeric antigen receptor T cells: Safety strategies to overcome toxicity.</a> Mol Cancer. 18 (1), 125 (2019).</li><li>Dana, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CAR-T+cells:+Early+successes+in+blood+cancer+and+challenges+in+solid+tumors.">CAR-T cells: Early successes in blood cancer and challenges in solid tumors.</a> Acta Pharm Sin B. 11 (5), 1129-1147 (2021).</li><li>Van Der Schans, J. J., Van De Donk, N., Mutis, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dual+targeting+to+overcome+current+challenges+in+multiple+myeloma+CAR+T-cell+treatment.">Dual targeting to overcome current challenges in multiple myeloma CAR T-cell treatment.</a> Front Oncol. 10, 1362 (2020).</li><li>Andrea, A. E., Chiron, A., Bessoles, S., Hacein-Bey-Abina, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Engineering+next-generation+car-t+cells+for+better+toxicity+management.">Engineering next-generation car-t cells for better toxicity management.</a> Int J Mol Sci. 21 (22), 8620 (2020).</li><li>Flugel, C. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Overcoming+on-target,+off-tumour+toxicity+of+CAR+T+cell+therapy+for+solid+tumours.">Overcoming on-target, off-tumour toxicity of CAR T cell therapy for solid tumours.</a> Nat Rev Clin Oncol. 20 (1), 49-62 (2023).</li><li>Rababah, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chimeric+antigen+receptor+T+cells+therapy+in+solid+tumors.">Chimeric antigen receptor T cells therapy in solid tumors.</a> Clin Transl Oncol. 25 (8), 2279-2296 (2023).</li><li>Masoud, G. 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Safety concerns are significant issues that must be addressed for any CAR-T cell therapy to advance to clinical use. Utilizing the unique properties of tumor cells or the TME has become a primary research direction focusing on the development of CAR-T cells that target tumor tissues selectively. Designing a hypoxia-sensitive CAR-T is an attractive strategy in this direction, with several approaches being explored, including the one presented in this study-fusing the CAR moiety with the naturally occurring hypoxia-sensing...

Chimeric antigen receptor T cell (CAR-T) therapy has represented a significant breakthrough in cancer treatment. Since the Food and Drug Administration (FDA) approved the first CAR-T therapy for treating advanced/resistant lymphoma and acute lymphoblastic leukemia in 20171,2,3, 10 CAR-T therapies targeting CD19 or B-cell maturation antigen (BCMA) have received approval globally4. However, despite extensive research, replicating the remarkable efficacy of CAR-T therapy in treating hematological malignancies remains challenging for its application to solid tumors5,6,7,8.
The immunosuppressive tumor microenvironment (TME) is a primary contributor to the poor efficacy of CAR-T in the solid tumor setting. TME impedes the activity and survival of CAR-T cells due to insufficient nutrients, hypoxia, an acidic pH, and the accumulation of metabolic waste9,10,11,12. Further hostility comes from infiltrating immunosuppressive cells such as regulatory T cells (Tregs), myeloid-derived suppressor cells (MDSCs), and tumor-associated macrophages (TAM), which, alongside tumor cells, secrete immunosuppressive cytokines that cause additional inhibition of CAR-T cells once they enter the tumor13,14.
Apart from the unsatisfactory therapeutic efficiency, safety issues are another Achilles&#39; heel of CAR-T cells when dealing with solid tumors15,16. The safety concern arises from the fact that none of the tumor-specific antigens (TSA) identified so far are strictly restricted to tumor cells. In other words, the tumor-associated antigens (TAA) chosen as the target of CAR, although showing higher expression in tumor cells, are often also expressed by normal tissues17. On-target, off-tumor effects could therefore occur from the unexpected activation of CAR-T cells upon CAR efficiently recognizing normal tissues, leading to cytokine release syndrome (CRS), CAR-T-related encephalopathy syndrome (CRES)18, and other adverse outcomes19.
Many strategies have been explored to avoid such effects, including decreasing the affinity of CAR to allow CAR-T cells to distinguish tumor cells from normal cells based on the expression levels of the targeted TAA; equipping CAR-T cells with an off switch, such as a suicide gene or elimination marker to promote their elimination upon unexpected activation; partitioning the CD3&#950; and co-stimulatory signals into two CAR moieties, whose simultaneous engagement is consequently required for effective activation of CAR-T cells; utilizing a synthetic Notch (synNotch)-based circuit that restricts the activity of CAR-T cells to targeted cells co-expressing two different TAAs; and engineering CAR-T cells to attain TME sensitivity by implementing a mechanism to tune CAR expression to changing environmental cues20,21,22,23,24,25,26.
A key consideration in the TME sensitivity option outlined above is the low oxygen level in the TME due to the rapid proliferation of tumor cells. The accommodation of tumor cells to hypoxia hinges on the activation of hypoxia-inducible factor-1 (HIF-1), a heterodimeric transcriptional factor consisting of an inducible subunit, HIF-1&#945;, and a constitutively expressed subunit, HIF-1&#946;27. Under normoxic conditions, the HIF-1&#945; protein undergoes ubiquitination and rapid proteasomal degradation, dependent on its oxygen-dependent degradation domain (ODD)28. When the cellular supply of oxygen becomes limited, HIF-1 is stabilized and activates the transcription of its downstream target genes by binding to hypoxia-response elements (HREs)29. Given the nature of ODD and HRE as oxygen-sensitive elements, they have been explored to realize the conditional expression of CARs within the hypoxic TME30. Here, we present a protocol focusing on methods for phenotypic and functional characterization of hypoxia-sensitive CAR-T cells, preceded by a brief description of the CAR design and the preparation procedures of these cells. This protocol intends to provide a useful guideline for exploiting hypoxia-responsive CAR to generate CAR-T cells with restrained off-tumor toxicity.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1.5 mL Centrifuge tube</td>
			<td>QSP</td>
			<td>509-GRD-Q</td>
			<td>Supernatants and cells cellection 
			Protocol Step 2,3,4</td>
		</tr>
		<tr>
			<td>10% ExpressCast PAGE</td>
			<td>NCM biotech</td>
			<td>P2012</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>10x PBS</td>
			<td>NCM biotech</td>
			<td>20220812</td>
			<td>Cell culture 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>10 mL pipette</td>
			<td>Yueyibio</td>
			<td>YB-25H</td>
			<td>Pipetting 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>10xTRIS-Glycine-SDS electrophoresis buffer</td>
			<td>Epizyme</td>
			<td>3673020</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>15 mL Centrifuge tube</td>
			<td>Thermo Scientific</td>
			<td>339650</td>
			<td>Supernatants and cells cellection 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>25 cm2 EasYFlask</td>
			<td>Thermo Scientific</td>
			<td>156367</td>
			<td>Cell culture 
			Protocol Step 3,4</td>
		</tr>
		<tr>
			<td>4x Protein SDS PAGE Loading Buffer</td>
			<td>Takara</td>
			<td>9173</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>6-well flat-bottom tissue culture plates</td>
			<td>Thermo Scientific</td>
			<td>140675</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>96-well black flat-bottom tissue culture plates</td>
			<td>Greiner</td>
			<td>655090</td>
			<td>Cytotoxicity assay 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>96-well ELISA plates</td>
			<td>Corning</td>
			<td>3590</td>
			<td>ELISA 
			Protocol Step 5</td>
		</tr>
		<tr>
			<td>96-well plate shaker</td>
			<td>QILINBEIER</td>
			<td>MH-2</td>
			<td>Shake 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>96-well U-bottom tissue culture plates</td>
			<td>Thermo Scientific</td>
			<td>268200</td>
			<td>Supernatants cellection 
			Protocol Step 4,5</td>
		</tr>
		<tr>
			<td>anti-FLAG antibody</td>
			<td>Sigma</td>
			<td>F1804-50UG</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Carbinol</td>
			<td>Sinopharm</td>
			<td>10010061</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Carbon dioxide incubator</td>
			<td>Thermo Scientific</td>
			<td>360</td>
			<td>Cell culture 
			Protocol Step 1,2,3,4</td>
		</tr>
		<tr>
			<td>Cell counting plate</td>
			<td>Hausser scientific</td>
			<td>1492</td>
			<td>Cell counting 
			Protocol Step 1,3,4</td>
		</tr>
		<tr>
			<td>CELLection Pan Mouse IgG Kit</td>
			<td>Thermo Scientific</td>
			<td>11531D</td>
			<td>Mouse IgG magnetic beads 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>Centrifuge</td>
			<td>Thermo Scientific</td>
			<td>75002432</td>
			<td>Cell culture 
			Protocol Step 1,3,4</td>
		</tr>
		<tr>
			<td>Chemiluminescence gel imaging system</td>
			<td>BIO-RAD</td>
			<td>12003154</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Cobalt chloride solution (0.5 M)</td>
			<td>bioleaper</td>
			<td>BR4000203</td>
			<td>Hypoxic condition 
			Protocol Step 2,3,4</td>
		</tr>
		<tr>
			<td>DMEM</td>
			<td>Corning</td>
			<td>10-103-CV</td>
			<td>Cell culture 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>Electronic balance</td>
			<td>Sartorius</td>
			<td>PRACTUM612-1CN</td>
			<td>weigh 
			Protocol Step 5</td>
		</tr>
		<tr>
			<td>FBS</td>
			<td>BI</td>
			<td>04-001-1ACS</td>
			<td>Cell culture 
			Protocol Step 3,4</td>
		</tr>
		<tr>
			<td>GAPDH Mouse mAb</td>
			<td>ABclonal</td>
			<td>AC002</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Gel electrophoresis apparatus</td>
			<td>BIO-RAD</td>
			<td>1645070</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>GloMax Microplate Readers</td>
			<td>Promega</td>
			<td>GM3000</td>
			<td>luciferase activity measurement 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>Goat anti-Mouse IgG (H+L)</td>
			<td>Yeasen</td>
			<td>P1126151</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>High speed microfreezing centrifuge</td>
			<td>eppendorf</td>
			<td>5810&#160;R</td>
			<td>Cell culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>Human IFN-&#947; ELISA Set</td>
			<td>BD</td>
			<td>555142</td>
			<td>ELISA 
			Protocol Step 5 
			Items: Recombinant Human IFN-&#947; Lyophilized Standard, Detection Antibody Biotin Anti-Human IFN-&#947; , Capture Antibody Purified Anti-Human IFN-&#947;, Enzyme Reagent Streptavidin-horseradish peroxidase conjugate (SAv-HRP)</td>
		</tr>
		<tr>
			<td>Human IL-2 ELISA Set</td>
			<td>BD</td>
			<td>555190</td>
			<td>ELISA 
			Protocol Step 5 
			Items: Recombinant Human IL-2 Lyophilized Standard, Detection Antibody Biotin Anti-Human IL-2 , Capture Antibody Purified Anti-Human IL-2, Enzyme Reagent Streptavidin-horseradish peroxidase conjugate (SAv-HRP)</td>
		</tr>
		<tr>
			<td>IL-15</td>
			<td>R&#38;D systems</td>
			<td>P40933</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>IL-21</td>
			<td>Novoprotein</td>
			<td>GMP-CC45</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>IL-7</td>
			<td>R&#38;D systems</td>
			<td>P13232</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>Inverted microscope</td>
			<td>Olympus</td>
			<td>CKX41</td>
			<td>Cell culture 
			Protocol Step 1,3,4</td>
		</tr>
		<tr>
			<td>Jurkat</td>
			<td>ATCC</td>
			<td>TIB-152</td>
			<td>CAR-Jurkat construction 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>LSRFortessa</td>
			<td>BD</td>
			<td>LSRFortessa</td>
			<td>Flow cytometry 
			Protocol Step 2</td>
		</tr>
		<tr>
			<td>Luciferase Assay System</td>
			<td>Promega</td>
			<td>E1501</td>
			<td>luciferase reporter assay 
			Protocol Step 4 
			Items: Passive lysis buffer, firefly luciferase substrate</td>
		</tr>
		<tr>
			<td>Microplate reader</td>
			<td>BioTek</td>
			<td>HTX</td>
			<td>ELISA 
			Protocol Step 5</td>
		</tr>
		<tr>
			<td>mobile CO2/O2/N2 Incubator Chamber</td>
			<td>China Innovation Instrument Co., Ltd.</td>
			<td>Smartor118</td>
			<td>Hypoxic condition 
			Protocol Step 2, 3, 4</td>
		</tr>
		<tr>
			<td>Mouse Anti-Hexa Histidine tag</td>
			<td>Sigma</td>
			<td>SAB2702218</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>NcmBlot Rapid Transfer Buffer</td>
			<td>NCM biotech</td>
			<td>WB4600</td>
			<td>Immunoblotting</td>
		</tr>
		<tr>
			<td>NcmECL Ultra</td>
			<td>NCM biotech</td>
			<td>P10300</td>
			<td>Immunoblotting 
			Protocol Step 3 
			Items: NcmECL Ultra Luminol/Enhancer Reagent (A) ,NcmECL Ultra Stabilized Peroxide Reagent (B)&#160;</td>
		</tr>
		<tr>
			<td>NovoNectin -coated 48-well flat plates</td>
			<td>Novoprotein</td>
			<td>GMP-CH38</td>
			<td>CAR-T cells construction 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>OPD (o-phenylenediamine dihydrochloride) tablet set</td>
			<td>Sigma</td>
			<td>P9187</td>
			<td>Substrate Reagent 
			Protocol Step 5 
			Items: OPD tablet (silver foil),urea hydrogen peroxide tablet (gold foil)</td>
		</tr>
		<tr>
			<td>PE-conjugated anti-DYKDDDDK</td>
			<td>Biolegend</td>
			<td>637310</td>
			<td>Flow cytometry 
			Protocol Step 2</td>
		</tr>
		<tr>
			<td>Protamine sulfate</td>
			<td>Sigma</td>
			<td>P3369-1OG</td>
			<td>Lentivirus infection 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>Protein Marker 10 Kda-250 KDa</td>
			<td>Epizyme</td>
			<td>WJ102</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>&#160;Purifed NA/LE Mouse Anti-Human CD3</td>
			<td>BD</td>
			<td>566685</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>Purified NA/LE Mouse Anti-Human CD28</td>
			<td>BD</td>
			<td>555725</td>
			<td>T Cells culture 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>PVDF membrane</td>
			<td>Millipore</td>
			<td>168627</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>RPMI 1640</td>
			<td>Corning</td>
			<td>10-040-CVRC</td>
			<td>Cell culture 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Skim milk powder</td>
			<td>Yeasen</td>
			<td>S9129060</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>SKOV3-Luc</td>
			<td>ATCC</td>
			<td>HTB-77</td>
			<td>Cytotoxicity assay 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>Trypsin-EDTA</td>
			<td>NCM biotech</td>
			<td>C125C1</td>
			<td>Cell culture 
			Protocol Step 4</td>
		</tr>
		<tr>
			<td>Tween 20</td>
			<td>Sinopharm</td>
			<td>30189328</td>
			<td>Immunoblotting 
			Protocol Step 3</td>
		</tr>
		<tr>
			<td>Water bath</td>
			<td>keelrein</td>
			<td>NB014467</td>
			<td>Heating 
			Protocol Step 1</td>
		</tr>
		<tr>
			<td>X-VIVO 15&#160;</td>
			<td>LONZA</td>
			<td>04-418Q</td>
			<td>Serum-free lymphocyte culture medium 
			Protocol Step 1</td>
		</tr>
	</tbody>
</table>

generation and functional verification of hypoxia-sensitive chimeric antigen receptor-t cells

Extensive studies have proven the promise of chimeric antigen receptor T (CAR-T) cell therapy in treating hematological malignancies. However, treating solid tumors remains challenging, as exemplified by the safety concerns that arise when CAR-T cells attack normal cells expressing the target antigens. Researchers have explored various approaches to enhance the tumor selectivity of CAR-T cell therapy. One representative strategy along this line is the construction of hypoxia-sensitive CAR-T cells, which are designed by fusing an oxygen-dependent degradation domain to the CAR moiety and are strategized to attain high CAR expression only in a hypoxic environment-the tumor microenvironment (TME). This paper presents a protocol for the generation of such CAR-T cells and their functional characterization, including methods to analyze the changes in CAR expression and killing capacity in response to different oxygen levels established by a mobile incubator chamber. The constructed CAR-T cells are anticipated to demonstrate CAR expression and cytotoxicity in an oxygen-sensitive manner, thus supporting their capability to distinguish between hypoxic TME and normoxic normal tissues for selective activation.

Author Spotlight: Advancements in Hypoxia-Sensitive CAR-T Therapy for Enhanced Cancer Immunotherapy

Generation and Functional Verification of Hypoxia-Sensitive Chimeric Antigen Receptor-T Cells

Our research primarily focuses on cancer immunotherapy, particularly in CAR T-cell-based immunotherapy. We have been exploring novel strategies during last 10 years to enable CAR T-cells to specifically target a tumor with minimizing the side effect or even no side effect at all. Novel strategy have been persistently explored to improve the safety and efficacy of the CAR T-cell-based immunotherapy, in particularly by targeting tumor microenvironment, such as hypoxia-conditioned CAR, as exemplified in this protocol.Interestingly, recent study demonstrated that hypoxia-condition CAR T not only greatly improved the safety profile, but also reduced the CAR T exhaustion and enhanced the efficacy in solid tumors. Hypoxia is a characteristic feature of tumor microenvironment. Our research aims to help researchers in the field of cancer immunotherapy understand the concept of hypoxia-sensitive CAR T-cells, their construction and how to establish hypoxia models for evaluation.Our laboratory will continue exploring new strategies for constructing CAR T-cells to enhance their tumor-curing efficacy, safety profile and cost effectiveness.

Fusing the ODD domain of HIF-1&#945; to the CAR moiety represents a primary strategy for generating a hypoxia-sensitive CAR. The hypoxia-sensitive HER2-targeting CAR analyzed in this study, named HER2-BBz-ODD, was constructed using this strategy by integrating the ODD sequence into its conventional HER2-BBz (Figure 1A). In this study, we used lentiviral transduction to express HER2-BBz-ODD CAR or HER2-BBz CAR and subsequently examined their oxygen sensitivity in two cell types: human PBMCs a...

Here we present a protocol for the generation and functional verification of hypoxia-sensitive chimeric antigen receptor (CAR)-T cells. This protocol presents the lentivirus-based generation of hypoxia-sensitive CAR-T cells and their characterization, including the validation of hypoxia-dependent CAR expression and selective cytotoxicity.

Extensive studies have proven the promise of chimeric antigen receptor T (CAR-T) cell therapy in treating hematological malignancies. However, treating ...

generation-functional-verification-hypoxia-sensitive-chimeric-antigen