针对 CAR-T 免疫效应细胞相关神经毒性综合征的生物学驱动疗法

Chimeric antigen receptor (CAR) T cell therapy, particularly CD19-directed CAR T cells, can induce immune effector cell-associated neurotoxicity syndrome (ICANS), leading to significant morbidity and the need for immunosuppressive treatment. In this review, we discuss the molecular mechanisms leading to ICANS, drawing insights from various preclinical models and translational studies.

We discuss pathophysiologic insights of ICANS from B-cell lymphoma-bearing mouse models, highlighting key differences between syngeneic and xenogeneic systems.

Additionally, we review diagnostic methods to detect ICANS such as MRI, CSF analyses, and translocator-protein-positron-emission-tomography (TSPO-PET).

Furthermore, we summarize current treatment recommendations and emerging therapeutic strategies aimed at mitigating ICANS. In summary, we provide a comprehensive overview of ICANS-pathophysiology, diagnostic approaches, and treatment interventions, with a focus on controlling immune dysregulation to prevent neurological complications.