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:CRISPR in Medicine: A Systematic Review of Clinical Trials and Therapeutic Applications.
研究结果强调了CRISPR/Cas9技术在各种疾病中的潜在作用。
成簇规律间隔短回文重复序列-CRISPR相关蛋白9(CRISPR/Cas9)技术已成为医学领域的一项革命性工具,为治疗多种疾病提供了巨大潜力,包括血液系统疾病、癌症、遗传性疾病和眼科疾病。本系统综述评估了CRISPR/Cas9在临床试验中的有效性、安全性和适用性。对PubMed、Scopus、Web of Science和Cochrane数据库进行了全面检索。纳入了截至2024年11月所有符合纳入标准、评估CRISPR用于疾病治疗的研究。使用Cochrane偏倚风险工具对纳入研究进行了质量评估。遵循系统综述和荟萃分析首选报告项目(PRISMA)2020声明,共纳入17项研究。本系统综述聚焦于CRISPR/Cas9技术在各种疾病中的有效性和安全性。在非恶性血液系统疾病中,CRISPR成功治疗了β-地中海贫血和镰状细胞病,实现了高输血非依赖性和疾病危象的消除。在恶性血液系统疾病中,B细胞急性淋巴细胞白血病方面,CRISPR工程化的CAR-T(CAR-T)细胞达到了83.3%的完全缓解率。此外,基于CRISPR的CAR-T细胞在B细胞非霍奇金淋巴瘤中显示出有前景的结果。在肿瘤学方面,肺癌和其他实体瘤是已使用CRISPR基因编辑技术进行安全工程化改造的疾病之一。对于遗传性疾病,CRISPR在视网膜变性中改善了视力,并减轻了遗传性血管性水肿和转甲状腺素蛋白淀粉样变性的症状,且副作用轻微。结果证明了CRISPR在广泛疾病中的潜力。总之,这些发现强调了CRISPR/Cas9技术在广泛疾病中的潜在作用。然而,挑战依然存在,包括优化递送系统、最小化脱靶效应、解决免疫原性问题以及伦理考量。
Clustered Regularly Interspaced Short Palindromic Repeats-CRISPR associated protein 9 (CRISPR/Cas9) technology has become a revolutionary tool in medicine, offering substantial potential for treating a wide range of diseases, including hematological disorders, cancers, genetic conditions, and ophthalmological diseases. This systematic review evaluates the efficacy, safety, and applicability of CRISPR/Cas9 in clinical trials. A comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane databases was conducted. All studies, up to November 2024, meeting the eligibility criteria assessing the application of CRISPR for the treatment of diseases were included. A quality assessment of the included studies was conducted using the Cochrane risk of bias tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement for systematic reviews and meta-analyses was followed, and a total of 17 studies were included. This systematic review of CRISPR/Cas9 technology focused on its effectiveness and safety across various diseases. In nonmalignant hematological disorders, CRISPR successfully treated -thalassemia and sickle cell disease, resulting in high transfusion independence and the elimination of disease crises. In malignant hematological disorders, B-cell acute lymphoblastic leukemia, CRISPR-engineered chimeric antigen receptor T (CAR-T) cells achieved an 83.3% complete remission rate. Furthermore, CRISPR-based CAR-T cells showed promising results in B-cell non-Hodgkin's lymphoma. In oncology, lung cancer and other solid tumors are among the diseases that have been safely engineered using CRISPR gene editing technology. For genetic disorders, CRISPR improved vision in retinal degeneration and reduced symptoms in hereditary angioedema and transthyretin amyloidosis with mild side effects. The results demonstrated CRISPR's potential across a wide range of conditions. In conclusion, the findings underscore the potential role of CRISPR/Cas9 technology across a wide range of diseases. However, challenges remain, including optimizing delivery systems, minimizing off-target effects, addressing immunogenicity concerns, and ethical considerations.
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