决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:CAR-NK Cells: A Chimeric Hope or a Promising Therapy?
CAR-NK Cells: A Chimeric Hope or a Promising Therapy?
嵌合抗原受体工程T细胞(CAR-T)免疫治疗已经彻底改变了复发/难治性B细胞恶性肿瘤的治疗格局。
利用嵌合抗原受体工程化T细胞(CAR-T)进行的免疫治疗已经彻底改变了复发/难治性B细胞恶性肿瘤的治疗格局。然而,使用自体T细胞存在某些局限性,包括所采集效应T细胞质量和数量的可变性、细胞处理时间延长、可用CAR细胞数量有限、毒性以及高成本。得益于其强大的细胞毒性能力,并已在单倍体相合造血干细胞移植以及针对实体瘤和血液系统恶性肿瘤的过继细胞治疗中证实具有抗肿瘤作用,Natural Killer细胞可能是一种有前景的替代选择。NK细胞可使用不同来源,包括细胞系、脐带血、外周血和诱导多能干细胞。其最大优势是可以在异基因环境中使用而没有重大毒性副作用。然而,关于CAR-NK细胞的大多数报告涉及临床前或早期临床试验。事实上,NK细胞可能更难进行工程化改造,并且扩增和转染方案的优化与标准化仍需明确。此外,其输注后持续时间短也是一个主要挫折。然而,随着近期在制造工程化CAR-NK细胞方面的进展,利用其溶细胞能力、抗体依赖性细胞介导的细胞毒性(ADCC)和细胞因子产生,“现货型”异基因CAR-NK细胞可在癌症治疗中提供巨大潜力。
Immunotherapy with chimeric antigen receptor-engineered T cells (CAR-T) has revolutionized the treatment landscape of relapsed/refractory B-cell malignancies. Nonetheless, the use of autologous T cells has certain limitations, including the variable quality and quantity of collected effector T cells, extended time of cell processing, limited number of available CAR cells, toxicities, and a high cost. Thanks to their powerful cytotoxic capabilities, with proven antitumor effects in both haploidentical hematopoietic stem cell transplantation and adoptive cell therapy against solid tumors and hematological malignancies, Natural Killer cells could be a promising alternative. Different sources of NK cells can be used, including cellular lines, cord blood, peripheral blood, and induced pluripotent stem cells. Their biggest advantage is the possibility of using them in an allogeneic context without major toxic side effects. However, the majority of the reports on CAR-NK cells concern preclinical or early clinical trials. Indeed, NK cells might be more difficult to engineer, and the optimization and standardization of expansion and transfection protocols need to be defined. Furthermore, their short persistence after infusion is also a major setback. However, with recent advances in manufacturing engineered CAR-NK cells exploiting their cytolytic capacities, antibody-dependent cellular cytotoxicity (ADCC), and cytokine production, "off-the-shelf" allogeneic CAR-NK cells can provide a great potential in cancer treatments.
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