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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:CAR-T cell technologies that interact with the tumour microenvironment in solid tumours.
CAR-T cell technologies that interact with the tumour microenvironment in solid tumours.
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在本综述中,我们描述了 CAR-T 细胞技术的一系列近期进展,这些进展旨在应对实体瘤带来的问题,包括肿瘤募集、浸润、免疫抑制、代谢受损和缺氧。
CAR-T 因能快速、特异杀伤肿瘤并形成持久免疫,已成为血液恶性肿瘤的突破性疗法,但实体瘤患者未见同等成功,主要障碍包括安全且均一的靶点选择困难、CAR-T 进入病灶不足及免疫抑制性肿瘤微环境。本文回顾自1987年CAR首次提出以来的研究,指出可通过进一步工程化CAR-T、增强其向病灶迁移和浸润,并逆转实体瘤中的抑制性免疫检查点来克服障碍。综述介绍近期技术进展,涵盖肿瘤募集、浸润、免疫抑制、代谢受损及缺氧等问题。
INTRODUCTION: Chimeric antigen receptor (CAR) T-cells have emerged as a ground-breaking therapy for the treatment of hematological malignancies due to their capacity for rapid tumor-specific killing and long-lasting tumor immunity.
However, the same success has not been observed in patients with solid tumors. Largely, this is due to the additional challenges imposed by safe and uniform target selection, inefficient CAR T-cell access to sites of disease and the presence of a hostile immunosuppressive tumor microenvironment. AREAS COVERED: Literature was reviewed on the PubMed database from the first description of a CAR by Kuwana, Kurosawa and colleagues in December 1987 through to the present day.
This literature indicates that in order to tackle solid tumors, CAR T-cells can be further engineered with additional armoring strategies that facilitate trafficking to and infiltration of malignant lesions together with reversal of suppressive immune checkpoints that operate within solid tumor lesions. EXPERT OPINION: In this review, we describe a number of recent advances in CAR T-cell technology that set out to combat the problems imposed by solid tumors including tumor recruitment, infiltration, immunosuppression, metabolic compromise, and hypoxia.
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