肿瘤细胞治疗研究
英文原题：Harnessing CAR-Extracellular Vesicles for Next-Generation Cancer Immunotherapy.
近年来，癌症免疫治疗取得了显著进展，尤其是随着嵌合抗原受体（CAR）技术的进步，该技术使免疫细胞能够选择性地靶向肿瘤相关抗原。
近年来，癌症免疫治疗取得了重大进展，尤其是随着嵌合抗原受体（CAR）技术的进步，该技术使免疫细胞能够选择性靶向肿瘤相关抗原。CAR现已发展至第五代，通过将单克隆抗体片段与信号传导域和共刺激域相结合进行工程化改造，并已成功应用于基于T细胞、自然杀伤（NK）细胞和巨噬细胞的疗法。诸如tisagenlecleucel和lisocabtagene maraleucel等显著的临床成功，凸显了CAR-T、CAR-NK和CAR-巨噬细胞（CAR-Ms）的治疗潜力，目前这些疗法正在大量临床试验中进行评估。该方法的一个有前景的延伸涉及使用源自这些免疫细胞的细胞外囊泡（EVs）。这些纳米级囊泡提供了一种无细胞平台，可递送多种抗癌介质，应对肿瘤环境的复杂性和动态性。在本综述中，我们探讨了CAR衍生EVs的治疗潜力和免疫原性特性，以及它们在调节免疫应答中的作用。此外，我们还探索了它们作为化疗药物靶向递送载体的应用，目标是在增强抗肿瘤疗效的同时尽量减少全身毒性。
Cancer immunotherapy has experienced substantial progress in recent years, particularly with the advancement of chimeric antigen receptor (CAR) technology, which enables immune cells to selectively target tumor-associated antigens. CARs, now in their fifth generation, are engineered by combining monoclonal antibody fragments with signaling and co-stimulatory domains and have been successfully applied to T cell, natural killer (NK) cell, and macrophage-based therapies. Notable clinical successes, such as tisagenlecleucel and lisocabtagene maraleucel underscore the therapeutic potential of CAR-T, CAR-NK and CAR-macrophages (CAR-Ms), which are currently being evaluated in numerous clinical trials. One promising extension of this approach involves the use of extracellular vesicles (EVs) derived from these immune cells. These nano-sized vesicles offer a cell-free platform to deliver diverse anticancer mediators, addressing the complex and dynamic nature of tumor environments. In this review, we examine the therapeutic potential and immunogenic properties of CAR-derived EVs, along with their role in modulating immune responses. Furthermore, we explore their application as targeted delivery vehicles for chemotherapeutic agents, with the goal of enhancing anti-tumor efficacy while minimizing systemic toxicity.
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