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:Beyond αβ T cells: NK, iNKT, and γδT cell biology in leukemic patients and potential for off-the-shelf adoptive cell therapies for AML.
急性髓系白血病(AML)仍是一种难以治疗的疾病,更不用说治愈,即使在干细胞移植等高度强化治疗后也是如此。
急性髓系白血病(AML)仍然难以治疗,更不用说治愈;即使采用造血干细胞移植等强度很高的治疗也是如此。基于常规 αβ T 细胞的过继性细胞疗法正在髓系肿瘤中积极研究,因为这类疗法在其他血液系统恶性肿瘤——尤其是 B 细胞来源的急性淋巴细胞白血病、多发性骨髓瘤和淋巴瘤——中已取得显著成功。AML 过继性细胞疗法的临床应用受到多方面限制,包括缺乏白血病特异性抗原、靶向肿瘤同时损伤正常组织的毒性、免疫抑制性微环境,以及难以被免疫系统识别和清除的白血病干细胞群。尽管包括嵌合抗原受体(CAR)T 细胞设计在内的 T 细胞疗法正在开发并显示前景,其他细胞毒性淋巴细胞亚群也具有独特表型和功能,可能为 AML 治疗带来额外益处。尤其值得关注的是自然杀伤(NK)细胞和非典型 T 细胞,包括不变型自然杀伤 T(iNKT)细胞和 γδ T 细胞。NK、iNKT 和 γδ T 细胞具有固有的抗恶性肿瘤特性、潜在异体反应性,且其功能不依赖人类白细胞抗原(HLA)。本文综述这些非典型细胞毒性淋巴细胞的生物学特征,并比较其作为 AML 过继性细胞疗法基础的优势与局限。
Acute myeloid leukemia (AML) remains an elusive disease to treat, let alone cure, even after highly intensive therapies such as stem cell transplants. Adoptive cell therapeutic strategies based on conventional alpha beta ( )T cells are an active area of research in myeloid neoplasms given their remarkable success in other hematologic malignancies, particularly B-cell-derived acute lymphoid leukemia, myeloma, and lymphomas. Several limitations have hindered clinical application of adoptive cell therapies in AML including lack of leukemia-specific antigens, on-target-off-leukemic toxicity, immunosuppressive microenvironments, and leukemic stem cell populations elusive to immune recognition and destruction. While there are promising T cell-based therapies including chimeric antigen receptor (CAR)-T designs under development, other cytotoxic lymphocyte cell subsets have unique phenotypes and capabilities that might be of additional benefit in AML treatment. Of particular interest are the natural killer (NK) and unconventional T cells known as invariant natural killer T (iNKT) and gamma delta ( ) T cells. NK, iNKT, and T cells exhibit intrinsic anti-malignant properties, potential for alloreactivity, and human leukocyte-antigen (HLA)-independent function. Here we review the biology of each of these unconventional cytotoxic lymphocyte cell types and compare and contrast their strengths and limitations as the basis for adoptive cell therapies for AML.
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