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:Immuno-inflammatory mechanisms in cardio-oncology: new hopes for immunotargeted therapies.
Immuno-inflammatory mechanisms in cardio-oncology: new hopes for immunotargeted therapies.
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肿瘤心脏病学是一个新兴跨学科领域,关注癌症患者癌症治疗相关心血管毒性(CTR-CVT)和合并心血管疾病(CVD)。炎症及免疫系统失调是肿瘤和心血管疾病的常见特征。除炎症造成的相互加重作用外,免疫治疗、化疗、放疗和靶向治疗等肿瘤治疗也可能诱发免疫炎症反应,导致心血管损伤。癌症免疫治疗目前已成为一种新型癌症治疗方法。免疫检查点抑制剂(ICI)、CAR-T 细胞免疫治疗、mRNA 疫苗等免疫治疗药物,可通过增强宿主免疫应答清除肿瘤细胞,发挥抗肿瘤作用。它们在临床上已取得显著疗效,但也导致多种免疫相关不良事件(irAE),其中包括 CTR-CVT。建立针对免疫治疗及抗炎治疗相关心血管毒性的专门评估、诊断和监测标准(如炎症生物标志物),对于指导临床实践至关重要。本文探讨免疫应答和炎症在肿瘤心脏病学中的作用,阐明潜在机制,并提出改进 CTR-CVT 监测和治疗的方法。
Cardio-oncology is an emerging interdisciplinary field concerned with cancer treatment-related cardiovascular toxicities (CTR-CVT) and concomitant cardiovascular diseases (CVD) in patients with cancer. Inflammation and immune system dysregulation are common features of tumors and cardiovascular disease (CVD).
In addition to the mutual exacerbating effect through inflammation, tumor treatments, including immunotherapy, chemotherapy, radiation therapy, and targeted therapy, may induce immune inflammatory reactions leading to cardiovascular damage. Cancer immunotherapy is currently a new method of cancer treatment. Immunotherapeutic agents, such as immune checkpoint inhibitors (ICIs), chimeric antigen receptor T cell immunotherapy (CAR-T), mRNA vaccines, etc. , can induce anti-tumor effects by enhancing the host immune response to eliminate tumor cells.
They have achieved remarkable therapeutic efficacy in clinical settings but lead to many immune-related adverse events (irAEs), especially CTR-CVT. Establishing specific evaluation, diagnostic, and monitoring criteria (e. g. , inflammatory biomarkers) for both immunotherapy and anti-inflammatory therapy-related cardiovascular toxicity is vital to guide clinical practice.
This article explores the role of immune response and inflammation in tumor cardiology, unravels the underlying mechanisms, and provides improved methods for monitoring and treating in CTR-CVT in the field of cardio-oncology.
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