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:CAR T cells redirected against tumor-specific antigen glycoforms: can low-sugar antigens guarantee a sweet success?
CAR T cells redirected against tumor-specific antigen glycoforms: can low-sugar antigens guarantee a sweet success?
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过去几十年,免疫治疗取得显著突破,多个适应证已获美国食品药品监督管理局(FDA)批准。目前已有 6 种CAR-T 细胞疗法获准用于部分复发/难治性血液系统恶性肿瘤患者。然而,多项实体瘤 CAR-T 临床试验被提前终止,或报告了危及生命的治疗相关健康组织损伤。健康器官和肿瘤细胞同时表达靶抗原是造成此类毒性的部分原因。除靶向肿瘤特异性抗原外,靶向肿瘤相关抗原的异常糖基化糖型也可能减少 CAR-T 对肿瘤外组织的影响。已有研究报告,Tn、T 和唾液酸化 Tn 抗原参与肿瘤进展和转移;一系列糖基转移酶及内质网蛋白伴侣 Cosmc 失调会导致这些抗原表达。此外,这些糖型与前列腺癌、乳腺癌、结肠癌、胃癌和肺癌等多种癌症相关。本文讨论低糖基化抗原的产生机制,并详述靶向此类抗原的 CAR-T 免疫疗法研发最新进展。
Immune-based therapies have experienced a pronounced breakthrough in the past decades as they acquired multiple US Food and Drug Administration (FDA) approvals for various indications. To date, six chimeric antigen receptor T cell (CAR-T) therapies have been permitted for the treatment of certain patients with relapsed/refractory hematologic malignancies.
However, several clinical trials of solid tumor CAR-T therapies were prematurely terminated, or they reported life-threatening treatment-related damages to healthy tissues. The simultaneous expression of target antigens by healthy organs and tumor cells is partly responsible for such toxicities.
Alongside targeting tumor-specific antigens, targeting the aberrantly glycosylated glycoforms of tumor-associated antigens can also minimize the off-tumor effects of CAR-T therapies. Tn, T, and sialyl-Tn antigens have been reported to be involved in tumor progression and metastasis, and their expression results from the dysregulation of a series of glycosyltransferases and the endoplasmic reticulum protein chaperone, Cosmc.
Moreover, these glycoforms have been associated with various types of cancers, including prostate, breast, colon, gastric, and lung cancers.
Here, we discuss how underglycosylated antigens emerge and then detail the latest advances in the development of CAR-T-based immunotherapies that target some of such antigens.
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