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:Disappearance of antiphospholipid antibodies after anti-CD19 chimeric antigen receptor T-cell therapy of B-cell lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome.
Disappearance of antiphospholipid antibodies after anti-CD19 chimeric antigen receptor T-cell therapy of B-cell lymphoma in a patient with systemic lupus erythematosus and antiphospholipid syndrome.
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抗磷脂综合征是一种自身免疫性疾病,其特征是在持续存在抗磷脂(aPL)抗体的情况下,自发发生静脉、动脉或微血管血栓形成和/或妊娠相关并发症(如流产、胎儿丢失)。当前最佳治疗方案是长期使用维生素 K 拮抗剂抗凝,以预防血栓事件复发,但这仅属于控制症状的治疗方法。迄今尚无根治性方案能够永久清除 aPL 抗体或针对潜在发病机制进行治疗。本文报告一名患系统性红斑狼疮和抗磷脂综合征、且 3 种 aPL 抗体均阳性的女性患者;她反复发生深静脉血栓。在接受CAR-T 细胞治疗侵袭性 B 细胞淋巴瘤后,观察到 3 种 aPL 抗体亚型持续清除,提示靶向抗 CD19 的免疫疗法有望用于治疗促血栓性自身免疫疾病。
Antiphospholipid syndrome is an autoimmune disorder characterized by the development of spontaneous venous, arterial, or microvascular thrombosis and/or pregnancy-related complications (eg, miscarriages, fetal loss) in the presence of persistent antiphospholipid (aPL) antibodies.
Current state-of-the-art treatment consists of indefinite anticoagulation with vitamin K antagonists to prevent recurrence of thrombotic events. This, however, represents only a symptom-control-oriented treatment approach. To date, no curative option eradicating aPL antibodies permanently or addressing the underlying pathomechanism has been established.
Here, we report the case of a woman with systemic lupus erythematosus and antiphospholipid syndrome with triple aPL antibody-positivity who developed recurrent deep venous thrombosis. After receiving chimeric antigen receptor T-cell therapy for aggressive B-cell lymphoma, sustained eradication of all 3 aPL antibody subtypes was observed, suggesting a promising role of immunotherapies targeting anti-CD19 for the treatment of prothrombotic autoimmune disorders.
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