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嵌合抗原受体(CAR)-自然杀伤(NK)细胞作为黑色素瘤治疗新途径的抗肿瘤特性

英文原题:Anticancer traits of chimeric antigen receptors (CARs)-Natural Killer (NK) cells as novel approaches for melanoma treatment.

PubMed 2022/11/25(内容时间) BMC Cancer Q2 · IF 4.1(JCR 2025)

研究概要

由于大量患者对常见的黑色素瘤疗法无应答,寻找新方法仍是一项尚未满足的需求。

中文摘要

由于许多患者对常见黑色素瘤疗法无应答,寻找新方法已成为未满足的需求。嵌合抗原受体(CAR)T细胞最初用于复发或难治性B细胞恶性肿瘤。然而,晚期或经多线治疗患者的T细胞数量不足(淋巴细胞减少),无法用于采集和临床治疗。此外,该流程耗时且后勤复杂。另一局限是毒性以及细胞因子释放综合征(CRS)和神经毒性综合征(NS)的发生。自然杀伤(NK)细胞是先天免疫的重要组成部分,在治疗应用中具有多项优势,包括易于获取、独特的生物学特征、安全性、成本效益以及更强的组织驻留能力。此外,CAR NK细胞不会引发移植物抗宿主病(GvHD),且不受宿主HLA基因型限制。值得注意的是,肿瘤微环境(TME)会影响NK细胞的数量和活性,因此可通过增强其成熟度和功能性开发新策略。CAR NK细胞寿命较短是一把双刃剑:既降低毒性,也削弱持续性。双特异性和三特异性杀伤细胞衔接器(BiKE和Trike)是促进抗体依赖性细胞毒作用(ADCC)的新兴、有前景的免疫疗法。CAR NK细胞仍面临扩增和供者细胞转导方面的限制,可能影响临床应答。CAR NK细胞治疗癌症的临床试验仍然很少。输注前照射会缩短CAR NK细胞寿命,限制其体内扩增并影响疗效。改善CAR NK细胞寿命、肿瘤微环境适应和稳定性,是黑色素瘤治疗的重要目标。联合CAR NK细胞与化疗也可能克服治疗局限。

展开英文摘要原文

Owing to non-responsiveness of a high number of patients to the common melanoma therapies, seeking novel approaches seem as an unmet requirement. Chimeric antigen receptor (CAR) T cells were initially employed against recurrent or refractory B cell malignancies. However, advanced stages or pretreated patients have insufficient T cells (lymphopenia) amount for collection and clinical application. Additionally, this process is time-consuming and logistically cumbersome. Another limitation of this approach is toxicity and cytokine release syndrome (CRS) progress and neurotoxicity syndrome (NS). Natural killer (NK) cells are a versatile component of the innate immunity and have several advantages over T cells in the application for therapies such as availability, unique biological features, safety profile, cost effectiveness and higher tissue residence. Additionally, CAR NK cells do not develop Graft-versus-host disease (GvHD) and are independent of host HLA genotype. Notably, the NK cells number and activity is affected in the tumor microenvironment (TME), paving the way for developing novel approaches by enhancing their maturation and functionality. The CAR NK cells short lifespan is a double edge sword declining toxicity and reducing their persistence. Bispecific and Trispecific Killer Cell Engagers (BiKE and Trike, respectively) are emerging and promising immunotherapies for efficient antibody dependent cell cytotoxicity (ADCC). CAR NK cells have some limitations in terms of expanding and transducing NK cells from donors to achieve clinical response. Clinical trials are in scarcity regarding the CAR NK cell-based cancer therapies. The CAR NK cells short life span following irradiation before infusion limits their efficiency inhibiting their in vivo expansion. The CAR NK cells efficacy enhancement in terms of lifespan TME preparation and stability is a goal for melanoma treatment. Combination therapies using CAR NK cells and chemotherapy can also overcome therapy limitations.

论文信息

作者
Bahmanyar M、Vakil MK、Al-Awsi GRL、Kouhpayeh SA、Mansoori Y、Mansoori B、Moravej A、Mazarzaei A
第一作者单位
Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.Iran
通讯作者单位
Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran. majidghasemian86@gmail.com.Iran
期刊
BMC cancer2022 Nov 25
原文标识
PubMed 36434591 · DOI 10.1186/s12885-022-10320-0