帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:AdMSC spheroids encapsulating antioxidant hybrid protein carrier for irradiation-damaged salivary gland repair.
这些结果证明了GC的ROS清除活性与AdMSC球体的旁分泌信号传导之间的协同效应。
头颈部肿瘤的放射治疗常导致口干症,这是一种由过量活性氧(ROS)驱动的慢性唾液腺(SG)功能障碍,严重影响患者的生活质量。现有治疗方法,如人工唾液或SG刺激剂,仅能提供暂时缓解。我们开发了一种新型治疗系统,将谷胱甘肽(GSH)偶联明胶(Gel)杂合蛋白基细胞载体(GC)与脂肪来源间充质干细胞(AdMSC)球体相结合。这种杂合蛋白载体(GC)通过克服GSH半衰期短的缺陷,延长了其抗氧化活性,并实现了AdMSC球体向辐照(IR)损伤SG的高效封装和递送。3D球体通过形成缺氧核心增强血管内皮生长因子(VEGF)表达,促进血管生成。在IR损伤小鼠模型中,封装球体的GC增加了SOD2表达,降低了8-OHdG和NOX4水平,有效减轻氧化应激、纤维化和凋亡,同时加速血管生成。组织学和免疫组织化学分析证实,封装球体的GC治疗后SG结构再生和功能恢复。这些结果证明了GC的ROS清除活性与AdMSC球体旁分泌信号传导的协同效应。这种具有突破性的封装球体GC通过整合抗氧化活性与血管生成效应,改善SG再生和功能恢复,为其他氧化应激介导的组织疾病提供了范式转变的解决方案。
Radiation therapy for head and neck cancer often causes xerostomia, a chronic salivary gland (SG) dysfunction driven by excessive reactive oxygen species (ROS), severely impacting the quality of life of patients. Existing treatments, such as artificial saliva or SG stimulants, offer only temporary relief. We developed a novel therapeutic system combining glutathione (GSH)-conjugated gelatin (Gel) hybrid protein-based cell carrier (GC) with adipose-derived mesenchymal stem cell (AdMSC) spheroids. This hybrid protein carrier (GC) extended the antioxidant activity of GSH by overcoming its short half-life and enabled efficient encapsulation and delivery of AdMSC spheroids to irradiation (IR)-damaged SGs. The 3D spheroids enhanced vascular endothelial growth factor (VEGF) expression through hypoxic core formation, promoting angiogenesis. In an IR-damaged mouse model, spheroid-encapsulated GC increased SOD2 expression and decreased 8-OHdG and NOX4 levels, effectively mitigating oxidative stress, fibrosis, and apoptosis, while accelerating angiogenesis. SG structural regeneration and functional recovery were confirmed using histological and immunohistochemical analyses following spheroid-encapsulating GC treatment. These results demonstrate the synergistic effects of ROS-scavenging activity from GC and paracrine signaling from AdMSC spheroids. This groundbreaking spheroid-encapsulating GC improves SG regeneration and functional recovery by integrating antioxidant activity with angiogenic effects, offering a paradigm-shifting solution for other oxidative stress-mediated tissue disorders.
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