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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
T 细胞免疫治疗与心血管疾病：CAR-T 细胞与双特异性 T 细胞衔接器治疗
英文原题：T-cell Immunotherapy and Cardiovascular Disease: Chimeric Antigen Receptor T-cell and Bispecific T-cell Engager Therapies.
查看英文原题
T-cell Immunotherapy and Cardiovascular Disease: Chimeric Antigen Receptor T-cell and Bispecific T-cell Engager Therapies.
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中文摘要
嵌合抗原受体（CAR）T 细胞和双特异性 T 细胞衔接器（BiTE）疗法彻底改变了难治或复发性白血病和淋巴瘤的治疗。随着这些疗法应用增加，已发现显著心脏毒性，包括心肌病/心力衰竭、心律失常、心肌损伤、血流动力学不稳定和心血管死亡；这些毒性主要发生在 CAR-T 细胞抗肿瘤效应引发的严重炎症反应——细胞因子释放综合征（CRS）背景下。既往存在的心血管风险因素和疾病可能增加此类心脏毒性风险。需高度警惕并密切监测，以便及时识别。支持性血流动力学管理和靶向抗 IL-6 治疗，以及可能使用的更广泛免疫抑制治疗（如糖皮质激素），是管理的基石。
展开英文摘要原文
Chimeric antigen receptor (CAR) T-cell and bispecific T-cell engager (BiTE) therapies have revolutionized the treatment of refractory or relapsed leukemia and lymphoma. Increased use of these therapies has revealed signals of significant cardiotoxicity, including cardiomyopathy/heart failure, arrhythmia, myocardial injury, hemodynamic instability, and cardiovascular death mainly in the context of a profound inflammatory response to CAR T-cell antitumor effects known as cytokine release syndrome (CRS).
Preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity. High index of suspicion and close monitoring is required for prompt recognition. Supportive hemodynamic care and targeted anti-IL-6 therapy, as well as possibly broader immunosuppression with corticosteroids, are the cornerstones of the management.
论文信息
- 作者
- Stein-Merlob AF、Ganatra S、Yang EH
- 第一作者单位
- Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA; Division of Cardiology, Department of Medicine, UCLA-Cardio-Oncology Program, University of California at Los Angeles, Los Angeles, CA, USA. Electronic address: https://twitter.com/A_SteinMerlob.United States
- 通讯作者单位
- Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA; Division of Cardiology, Department of Medicine, UCLA-Cardio-Oncology Program, University of California at Los Angeles, Los Angeles, CA, USA. Electronic address: ehyang@mednet.ucla.edu.United States
- 文献类型
- 综述
- 期刊
- Heart failure clinics2022 Jul
- 原文标识
- PubMed 35718418 · DOI 10.1016/j.hfc.2022.02.008