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:Chimeric antigen receptor-natural killer cells: a promising sword against insidious tumor cells.
Chimeric antigen receptor-natural killer cells: a promising sword against insidious tumor cells.
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自然杀伤(NK)细胞是固有免疫的重要组成部分,尤其在初始肿瘤识别和抑制进一步肿瘤生长或转移播散方面发挥关键作用。NK细胞无需预先致敏即可通过刺激性受体识别转化细胞并迅速将其清除。
然而,保护性肿瘤微环境通过诱导免疫细胞(包括NK细胞)进入耗竭状态,促进肿瘤逃逸。因此,通过基因改造NK细胞以特异性识别肿瘤相关抗原或对肿瘤细胞产生更强应答,是增强NK细胞杀肿瘤能力的一种有前景的策略。鉴于工程化CAR-T 细胞在治疗血液系统恶性肿瘤方面取得的显著成就,CAR-NK细胞在肿瘤免疫治疗中的应用日益受到关注。NK细胞的固有功能、更高的安全性、更优的体内维持能力以及现货供应的潜力,使基于CAR-NK的治疗优于CAR-T 细胞治疗。在本综述中,我们全面讨论了CAR-NK细胞制造中近期的基因操作,涉及CAR构建体的不同结构域及其随后递送至不同来源NK细胞的递送系统。然后重点介绍了CAR-NK细胞的临床前和临床研究,并探讨了其作为肿瘤免疫治疗中一种乐观疗法的当前挑战和前景。
Natural killer (NK) cells are a critical component of innate immunity, particularly in initial cancer recognition and inhibition of additional tumor growth or metastasis propagation. NK cells recognize transformed cells without prior sensitization via stimulatory receptors and rapidly eradicate them.
However, the protective tumor microenvironment facilitates tumor escaping via induction of an exhaustion state in immune cells, including NK cells. Hence, genetic manipulation of NK cells for specific identification of tumor-associated antigens or a more robust response against tumor cells is a promising strategy for NK cells' tumoricidal augmentation. Regarding the remarkable achievement of engineered CAR-T cells in treating hematologic malignancies, there is evolving interest in CAR-NK cell recruitment in cancer immunotherapy.
Innate functionality of NK cells, higher safety, superior in vivo maintenance, and the off-the-shelf potential move CAR-NK-based therapy superior to CAR-T cells treatment. In this review, we have comprehensively discussed the recent genetic manipulations of CAR-NK cell manufacturing regarding different domains of CAR constructs and their following delivery systems into diverse sources of NK cells.
Then highlight the preclinical and clinical investigations of CAR-NK cells and examine the current challenges and prospects as an optimistic remedy in cancer immunotherapy.
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