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:Cytokine-induced killer cells: new insights for therapy of hematologic malignancies.
Cytokine-induced killer cells: new insights for therapy of hematologic malignancies.
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CIK 细胞在血液系统恶性肿瘤的治疗中显示出有希望的结果,尤其是与其他抗肿瘤策略联合应用时。然而,在实现理想临床反应方面存在的争议凸显了未来研究的重要性。
细胞因子诱导的杀伤(CIK)细胞是一类新型免疫效应细胞亚群,被归类为用于免疫治疗的修饰T细胞介导手段之一。这些细胞对血液系统恶性肿瘤和实体恶性肿瘤均发挥MHC非限制性细胞毒性作用,且治疗相关严重并发症发生率低。本研究综述了CIK细胞在治疗血液系统恶性肿瘤病例中的应用。主要内容:CIK细胞由CD3+/CD56+自然杀伤(NK)T细胞、CD3-/CD56+NK细胞和CD3+/CD56-细胞毒性T细胞组成。在这方面,CD3+/CD56+NK T细胞是主要效应细胞。与既往报道的抗肿瘤免疫细胞相比,CIK细胞的特点是体外增殖和扩增能力增强、向肿瘤区域迁移和侵袭的能力增强、抗肿瘤活性更显著,以及抗肿瘤谱更广。CIK细胞还可通过多种途径和机制诱导肿瘤细胞死亡。因此,基于CIK的疗法已用于多种临床试验,并已在多种癌症中显示出疗效,包括血液系统恶性肿瘤,甚至包括复发病例或对其他治疗无反应的病例,且移植物抗宿主病(GVHD)发生率极低。尽管T细胞含量高,CIK细胞诱导的异体反应性低,因此即使在MHC不匹配移植病例中,其诱导GVHD的风险也有限。CIK细胞疗法的1期和2期临床试验也凸显了其对血液系统癌症令人满意的治疗优势,表明即使在单倍体相合移植情况下CIK细胞也是安全的。
Cytokine-induced killer (CIK) cells are a novel subgroup of immune effectors, classified as one of the modified T cell-mediated arms for immunotherapy. These cells exert MHC-unrestricted cytotoxicity against both hematological and solid malignancies with low incidence of treatment-related severe complications. This study reviews the application of CIK cells in treating cases with hematologic malignancies. MAIN BODY: CIK cells consist of CD3 + /CD56 + natural killer (NK) T cells, CD3 - /CD56 + NK cells, and CD3 + /CD56 - cytotoxic T cells. In this regard, the CD3 + /CD56 + NK T cells are the primary effectors. Compared with the previously reported antitumor immune cells, CIK cells are characterized by improved in vitro proliferation and amplification, enhanced migration and invasive capacity to tumor region, more significant antitumor activity, and a broader antitumor spectrum. CIK cells can also induce death in tumor cells via numerous pathways and mechanisms. Hence, CIKs-based therapy has been used in various clinical trials and has shown efficacy with a very low graft versus host disease (GVHD) against several cancers, such as hematologic malignancies, even in relapsing cases, or cases not responding to other therapies. Despite the high content of T cells, CIK cells induce low alloreactivity and, thus, pose a restricted threat of GVHD induction even in MHC-mismatched transplantation cases. Phase 1 and 2 clinical trials of CIK cell therapy have also highlighted satisfactory therapeutic advantages against hematologic cancers, indicating the safety of CIK cells even in haploidentical transplantation settings.
CIK cells have shown promising results in the treatment of hematologic malignancies, especially in combination with other antitumor strategies. However, the existing controversies in achieving desired clinical responses underscore the importance of future studies.
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