肿瘤细胞治疗研究
英文原题:Gene transfer and genome editing of T cells for cancer immunotherapy: from allogeneic HSCT to TCR gene editing.
Gene transfer and genome editing of T cells for cancer immunotherapy: from allogeneic HSCT to TCR gene editing.
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过继性 T 细胞疗法已成为癌症免疫治疗中一种变革性的治疗方式,其建立于异基因造血干细胞移植所确立的基础原理之上。在这一背景下,供者 T 细胞虽可介导治愈性的移植物抗白血病和移植物抗感染效应,但其同种反应性也带来显著风险。基因转移策略——如自杀基因插入——使得在发生不良事件时可选择性清除 T 细胞,从而更安全地使用供者淋巴细胞。通过这一最初的基因治疗方法,人们获得了关于工程化 T 细胞功能、持久性、安全性和疗效的若干经验。近年来,基因组编辑技术的进步使得能够精确操控 T 细胞基因组和功能,包括破坏内源性 T 细胞受体(TCR)以及插入肿瘤特异性受体,如嵌合抗原受体和肿瘤特异性 TCR。针对持久性和抗免疫抑制进行优化的 T 细胞制备方案——很大程度上得益于在同一细胞中同时编辑多个基因(多重基因组编辑)的可能性——的整合,已将工程化 T 细胞定位为可编程且持久的治疗药物。
在此,我们简要回顾 T 细胞基因工程的关键里程碑、挑战和创新,从异基因造血干细胞移植到下一代 TCR 编辑免疫治疗。
Adoptive T-cell therapy has emerged as a transformative modality in cancer immunotherapy, building upon foundational principles established in allogeneic hematopoietic stem cell transplantation. In this setting, while donor T cells mediate curative graft-versus-leukemia and graft-versus-infection effects, their alloreactivity poses significant risks. Gene transfer strategies-such as suicide gene insertion-have enabled the safer use of donor lymphocytes by allowing the selective elimination of T cells in case of adverse events. With this initial gene therapy approach, several lessons on the function, persistence, safety, and efficacy of engineered T cells were learned.
More recently, advances in genome editing technologies have enabled precise manipulation of T-cell genomes and function, including disruption of endogenous T-cell receptors (TCRs) and insertion of tumor-specific receptors, such as chimeric antigen receptors and tumor-specific TCRs.
Integration of T-cell manufacturing protocols optimized for persistence and resistance to immune suppression-largely facilitated by the possibility to simultaneously edit multiple genes (multiplex genome editing) in the same cells-has positioned engineered T cells as programmable and persistent therapeutics.
Here, we briefly review key milestones, challenges, and innovations in T-cell gene engineering, from allogeneic hematopoietic stem cell transplantation to next-generation TCR-edited immunotherapies.
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