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
英文原题:Cell metabolism-based optimization strategy of CAR-T cell function in cancer therapy.
Cell metabolism-based optimization strategy of CAR-T cell function in cancer therapy.
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使用嵌合抗原受体(CAR)修饰的T细胞进行的过继细胞治疗(ACT)已经彻底改变了免疫肿瘤学领域,在血液系统恶性肿瘤中显示出显著疗效。然而,其在实体瘤中的成功受到易复发和疗效不佳等因素的限制。CAR-T 细胞的效应功能和持久性对治疗成功至关重要,并受到代谢和营养感应机制的调控。此外,免疫抑制性肿瘤微环境(TME)以酸性、缺氧、营养耗竭以及由肿瘤细胞高代谢需求引起的代谢物积累为特征,可导致T细胞“耗竭”并削弱CAR-T 细胞的疗效。在这篇综述中,我们概述了T细胞在不同分化阶段的代谢特征,并总结了这些代谢程序在TME中可能如何被破坏。我们还讨论了提高CAR-T 细胞疗效和持久性的潜在代谢策略,为CAR-T 细胞治疗的临床应用提供了新策略。
Adoptive cell therapy (ACT) using chimeric antigen receptor (CAR)-modified T cells has revolutionized the field of immune-oncology, showing remarkable efficacy against hematological malignancies.
However, its success in solid tumors is limited by factors such as easy recurrence and poor efficacy. The effector function and persistence of CAR-T cells are critical to the success of therapy and are modulated by metabolic and nutrient-sensing mechanisms.
Moreover, the immunosuppressive tumor microenvironment (TME), characterized by acidity, hypoxia, nutrient depletion, and metabolite accumulation caused by the high metabolic demands of tumor cells, can lead to T cell "exhaustion" and compromise the efficacy of CAR-T cells. In this review, we outline the metabolic characteristics of T cells at different stages of differentiation and summarize how these metabolic programs may be disrupted in the TME.
We also discuss potential metabolic approaches to improve the efficacy and persistence of CAR-T cells, providing a new strategy for the clinical application of CAR-T cell therapy.
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