决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Common gamma chain cytokines-driven optimization of chimeric antigen receptor T cells: Mechanistic insights and future directions.
恶性肿瘤对人类生命健康构成重大威胁,在医学研究中始终是持续存在的挑战。
恶性肿瘤对人类生命健康构成重大威胁,是医学研究中持续面临的挑战。尽管CAR-T(CAR-T)细胞疗法在白血病、淋巴瘤等血液系统恶性肿瘤中已展现出突破性疗效,但其在肝细胞癌、肺癌、胰腺癌等实体瘤中的应用仍受限于多重瓶颈。这些局限包括免疫抑制性肿瘤微环境、CAR-T细胞体内持久性不足、长期治疗诱导的耗竭以及脱靶毒性。白细胞介素(IL)-2家族细胞因子,包括IL-2、IL-4、IL-7、IL-9、IL-15和IL-21,也称为γ链(c)细胞因子,共享c(CD132)-Janus激酶1/3-信号转导及转录激活因子信号轴。这些细胞因子精确调控T细胞和NK 细胞等免疫细胞的存活、增殖和功能分化。在CAR-T免疫治疗中,c细胞因子应用于四个核心场景:促进体外CAR-T细胞高效扩增以满足治疗剂量需求;增强体内持久性以延长治疗窗口;强化效应功能以对抗肿瘤微环境介导的抑制;以及实现精确的细胞因子释放以降低毒性风险。技术策略已从早期重组蛋白给药(体外和体内)发展到第二代工程化自分泌细胞因子的“装甲”CAR-T细胞,并进一步发展到利用合成生物学实现时空控制的第三代可编程细胞因子回路。本综述系统总结了c细胞因子在优化CAR-T细胞功能中的机制作用、研究进展和技术演进。它批判性地分析了不同应用策略的优势与局限性,并探讨了其在克服实体瘤治疗瓶颈、同时提高CAR-T疗法安全性和有效性方面的潜力。这些见解旨在为该领域的基础研究和临床转化提供参考。
Malignant tumors represent a major threat to human life and health, posing persistent challenges in medical research. While chimeric antigen receptor T (CAR-T) cell therapy has demonstrated breakthrough efficacy in hematological malignancies such as leukemia and lymphoma, its application in solid tumors, including hepatocellular carcinoma, lung cancer, and pancreatic cancer, remains constrained by multiple bottlenecks. These limitations encompass the immunosuppressive tumor microenvironment, insufficient in vivo persistence of CAR-T cells, long-term treatment-induced exhaustion, and off-target toxicity. The interleukin (IL)-2 family cytokines, IL-2, IL-4, IL-7, IL-9, IL-15, and IL-21, also known as gamma chain ( c) cytokines, share the c (CD132)-Janus kinase 1/3-signal transducer and activator of transcription signaling axis. These cytokines precisely regulate the survival, proliferation, and functional differentiation of immune cells, including T cells and natural killer cells. In CAR-T immunotherapy, c cytokines are applied in four core scenarios: Facilitating efficient in vitro CAR-T cell expansion to meet therapeutic dosing requirements; enhancing in vivo persistence to extend the therapeutic window; reinforcing effector functions to counteract tumor microenvironment-mediated suppression; and enabling precise cytokine release to mitigate toxicity risks. Technological strategies have evolved from early recombinant protein administration ( in vitro and in vivo ) to second-generation "armored" CAR-T cells engineered for autocrine cytokine secretion and further to third-generation programmable cytokine circuits using synthetic biology for spatiotemporal control. This review systematically summarizes the mechanistic roles, research progress, and technological evolution of c cytokines in optimizing CAR-T cell function. It critically analyzes the advantages and limitations of different application strategies and explores their potential to overcome solid tumor treatment bottlenecks while improving CAR-T therapy safety and efficacy. These insights aim to inform basic research and clinical translation in this field.
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