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:Cytokine Release Syndrome in the Immunotherapy of Hematological Malignancies: The Biology behind and Possible Clinical Consequences.
Cytokine Release Syndrome in the Immunotherapy of Hematological Malignancies: The Biology behind and Possible Clinical Consequences.
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细胞因子释放综合征(CRS)是一种急性全身炎症综合征,特征为发热和多器官功能障碍,可发生于(1)嵌合抗原受体(CAR)T细胞治疗、(2)治疗性抗体使用以及(3)单倍型相合异基因干细胞移植之后。部分病例可出现危及生命的重度CRS,需要及时处理相关毒性,这仍是临床医生面临的重大挑战。CRS病理生理机制尚未完全阐明,能够提前预测其发生的生物标志物也尚未确定。不过,多种细胞因子参与CRS的动态发展。治疗策略包括广谱免疫抑制剂(如皮质类固醇)以及更具特异性的细胞因子阻断。本综述介绍这一严重并发症在病理生理机制、病因、诊断和治疗选择方面的最新认识。
Cytokine release syndrome (CRS) is an acute systemic inflammatory syndrome characterized by fever and multiple organ dysfunction associated with (i) chimeric antigen receptor (CAR)-T cell therapy, (ii) therapeutic antibodies, and (iii) haploidentical allogeneic stem cell transplantation (haplo-allo-HSCT).
Severe CRS can be life-threatening in some cases and requires prompt management of those toxicities and is still a great challenge for physicians. The pathophysiology of CRS is still not fully understood, which also applies to the identifications of predictive biomarkers that can forecast these features in advance.
However, a broad range of cytokines are involved in the dynamics of CRS. Treatment approaches include both broad spectrum of immunosuppressant, such as corticosteroids, as well as more specific inhibition of cytokine release. In the present manuscript we will try to review an update regarding pathophysiology, etiology, diagnostics, and therapeutic options for this serious complication.
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