CAR T-Cells Depend on the Coupling of NADH Oxidation with ATP Production. Author Juan García-Cañaveras, David Heo, Sophie Trefely, John Leferovich, Chong Xu, Benjamin Philipson, Saba Ghassemi, Michael Milone, Edmund Moon, Nathaniel Snyder, Carl June, Joshua Rabinowitz, Roddy O'Connor Publication Year 2021 Type Journal Article Abstract The metabolic milieu of solid tumors provides a barrier to chimeric antigen receptor (CAR) T-cell therapies. Excessive lactate or hypoxia suppresses T-cell growth, through mechanisms including NADH buildup and the depletion of oxidized metabolites. NADH is converted into NAD by the enzyme NADH Oxidase (), which mimics the oxidative function of the electron transport chain without generating ATP. Here we determine if promotes human CAR T-cell metabolic activity and antitumor efficacy. CAR T-cells expressing have enhanced oxygen as well as lactate consumption and increased pyruvate production. renders CAR T-cells resilient to lactate dehydrogenase inhibition. But in vivo in a model of mesothelioma, CAR T-cell's expressing showed no increased antitumor efficacy over control CAR T-cells. We hypothesize that T cells in hostile environments face dual metabolic stressors of excessive NADH and insufficient ATP production. Accordingly, futile T-cell NADH oxidation by is insufficient to promote tumor clearance. Keywords Animals, Mice, Humans, Adenosine Triphosphate, Female, Male, Adult, Oxidation-Reduction, NAD, NADH, NADPH Oxidoreductases, Mice, Inbred NOD, T-Lymphocytes, Multienzyme Complexes, Mice, SCID, Receptors, Antigen, T-Cell, Levilactobacillus brevis Journal Cells Volume 10 Issue 9 Date Published 2021 Sep 06 ISSN Number 2073-4409 DOI 10.3390/cells10092334 Alternate Journal Cells PMCID PMC8472053 PMID 34571983 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML