CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Chimeric Antigen Receptor-Engineered Natural Killer (CAR NK) Cells in Cancer Treatment; Recent Advances and Future Prospects.
Chimeric Antigen Receptor-Engineered Natural Killer (CAR NK) Cells in Cancer Treatment; Recent Advances and Future Prospects.
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自然杀伤(NK)细胞是先天免疫淋巴细胞的重要成员,在宿主抵御恶性细胞方面发挥关键作用。采用嵌合抗原受体(CAR)的过继细胞治疗(ACT)可重新定向免疫细胞,使其特异性识别靶抗原。ACT近来为癌症治疗带来了重大机遇。与CAR-T 细胞相比,NK细胞具有不依赖主要组织相容性复合体(MHC)、寿命较短、可能制成现货型免疫产品以及抗肿瘤活性强等特点,因此成为表达CAR的有力替代细胞。本文概述CAR NK设计和免疫生物学的最新进展,并介绍CAR修饰NK细胞作为现货型CAR载体的潜力。
我们还列出CAR NK生产所用的NK细胞来源、将CAR基因序列转导至NK细胞的不同方法、CAR-T 与CAR NK的差异,以及当前研究中CAR NK靶向的肿瘤抗原。
此外,我们汇总了近期发表的CAR NK临床前和临床研究数据,以及已完成和正在开展的临床试验。为提高CAR NK产品的疗效和安全性,我们讨论了CAR NK转导和扩增方面的挑战、CAR NK治疗的不良反应,以及限制其最佳疗效的因素,并提出可能的解决方案,以增强CAR NK细胞在实体瘤等场景中的持续性、功能、安全性和疗效。
Natural Killer (NK) cells are critical members of the innate immunity lymphocytes and have a critical role in host defense against malignant cells. Adoptive cell therapy (ACT) using chimeric antigen receptor (CAR) redirects the specificity of the immune cell against a target-specific antigen. ACT has recently created an outstanding opportunity for cancer treatment.
Unlike CAR-armored T cells which hadnsome shortcomings as the CAR-receiving construct, Major histocompatibility complex (MHC)-independency, shorter lifespan, the potential to produce an off-the-shelf immune product, and potent anti-tumor properties of the NK cells has introduced NK cells as a potent alternative target for expression of CAR.
Here, we aim to provide an updated overview on the current improvements in CAR NK design and immunobiology and describe the potential of CAR-modified NK cells as an alternative "off-the-shelf" carrier of CAR.
We also provide lists for the sources of NK cells in the process of CAR NK cell production, different methods for transduction of the CAR genetic sequence to NK cells, the differences between CAR T and CAR NK, and CAR NK-targeted tumor antigens in current studies.
Additionally, we provide data on recently published preclinical and clinical studies of CAR NK therapy and a list of finished and ongoing clinical trials. For achieving CAR NK products with higher efficacy and safety, we discuss current challenges in transduction and expansion of CAR NK cells, CAR NK therapy side effects, and challenges that limit the optimal efficacy of CAR NK cells and recommend possible solutions to enhance the persistence, function, safety, and efficacy of CAR NK cells with a special focus on solid tumors.
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