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:Chimeric switch and inverted cytokine receptors in T cell therapy: reprogramming T cells to overcome immune suppression in the solid tumor microenvironment.
Chimeric switch and inverted cytokine receptors in T cell therapy: reprogramming T cells to overcome immune suppression in the solid tumor microenvironment.
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过继T细胞疗法已改变癌症治疗,嵌合抗原受体(CAR)T细胞疗法在血液系统恶性肿瘤中取得了显著临床成功。通过基因工程改造患者自身T细胞,使其识别并攻击癌细胞,CAR-T 疗法已使多种血液癌症实现持久缓解。然而,其治疗实体瘤的疗效仍有限,主要原因是免疫抑制性肿瘤微环境(TME)会损害T细胞浸润、持续存在和功能。为应对这些挑战,研究者正开发创新策略,在恶劣的TME中重编程T细胞信号传导。一类有前景的方法是嵌合非抗原受体(CNAR),可不依赖直接抗原识别而调节T细胞活性。其中,嵌合转换受体(CSR)可将抑制性检查点信号转变为活化信号;反向细胞因子受体(ICR)则可重新导向抑制性细胞因子信号,促进T细胞活化。本综述重点介绍CSR和ICR作为CAR-T 实体瘤治疗辅助策略的设计原则、作用机制和治疗潜力,并讨论安全性、特异性及临床转化等关键考量,为未来癌症免疫治疗工程化受体策略的发展提供参考。
Adoptive T cell therapy has transformed cancer treatment, with chimeric antigen receptor (CAR) T cell therapy demonstrating remarkable clinical success in hematological malignancies. By genetically engineering a patient's own T cells to recognize and attack cancer cells, CAR T therapy has achieved durable remissions in several blood cancers.
However, its efficacy in solid tumors remains limited, largely due to the immunosuppressive tumor microenvironment (TME), which impairs T cell infiltration, persistence, and function. To address these challenges, innovative strategies are being developed to reprogram T cell signaling within the hostile TME. One promising class involves chimeric non-antigen receptors (CNARs), which modulate T cell activity independently of direct antigen recognition.
Among these, chimeric switch receptors (CSRs) convert inhibitory checkpoint signals into activating cues, while inverted cytokine receptors (ICRs) redirect suppressive cytokine signals to promote T cell activation. In this review, we provide a focused overview of the design principles, mechanistic functions, and therapeutic potentials of CSRs and ICRs as adjuncts to CAR T therapy in solid tumors.
We also discuss key considerations regarding safety, specificity, and clinical translation to inform future advancements in engineered receptor strategies for cancer immunotherapy.
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