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research article

Age-associated nicotinamide adenine dinucleotide decline drives CAR-T cell failure

Hope, Helen Carrasco
•
de Sostoa, Jana
•
Ginefra, Pierpaolo
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May 20, 2025
Nature Cancer

Chimeric antigen receptor (CAR) T cell therapy is one of the most promising cancer treatments. However, different hurdles are limiting its application and efficacy. In this context, how aging influences CAR-T cell outcomes is largely unknown. Here we show that CAR-T cells generated from aged female mice present a mitochondrial dysfunction derived from nicotinamide adenine dinucleotide (NAD) depletion that leads to poor stem-like properties and limited functionality in vivo. Moreover, human data analysis revealed that both age and NAD metabolism determine the responsiveness to CAR-T cell therapy. Targeting NAD pathways, we were able to recover the mitochondrial fitness and functionality of CAR-T cells derived from older adults. Altogether, our study demonstrates that aging is a limiting factor to successful CAR-T cell responses. Repairing metabolic and functional obstacles derived from age, such as NAD decline, is a promising strategy to improve current and future CAR-T cell therapies.

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10.1038_s43018-025-00982-7.pdf

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Main Document

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Published version

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openaccess

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CC BY

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10.61 MB

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edc1035e1b3b8bf6f77908f5eef497aa

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