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诱导多能干细胞来源 NK 细胞作为肿瘤免疫治疗的现货型平台:机遇、挑战与临床转化

英文原题:Induced Pluripotent Stem Cell-Derived NK Cells as an Off-the-Shelf Platform for Cancer Immunotherapy: Opportunities, Challenges, and Clinical Translation.

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Induced Pluripotent Stem Cell-Derived NK Cells as an Off-the-Shelf Platform for Cancer Immunotherapy: Opportunities, Challenges, and Clinical Translation.

PubMed 2026/05/26(内容时间) Stem Cell Rev Rep Q2 · IF 4.9(JCR 2025)

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中文摘要

近年来,现货型细胞免疫疗法作为自体疗法的实用替代方案受到广泛关注。在这一领域中,诱导多能干细胞来源NK 细胞(iPSC-NK)已成为高度灵活的平台,因为其兼具可持续的起始细胞来源、批次间一致性、良好的内在安全性以及精准基因工程适用性。本综述将iPSC-NK细胞置于更广泛的NK细胞免疫治疗领域中,比较其与外周血来源NK细胞、脐带血来源NK细胞及NK细胞系(包括临床研究中的NK-92平台)的差异,并概述NK细胞疗法与CAR-T 方法的主要区别。

我们总结iPSC向NK细胞分化的现有策略,包括饲养层系统、无饲养层方案、胚状体方法及可扩展且符合GMP要求的生产方法。我们进一步讨论NK细胞基因工程策略,特别强调将遗传调控作为系统层面的框架,以协调CAR信号、细胞因子响应及激活-抑制平衡,从而在保持功能稳定性和临床安全性的同时提高抗肿瘤效力。

此外,本综述考察仍限制NK细胞更广泛应用的转化挑战,包括功能成熟不充分、持久性有限、供者及来源相关变异、生产标准化、冻存以及质量控制要求。iPSC-NK产品的早期临床研究显示,其安全性良好,并在部分血液系统恶性肿瘤中呈现初步抗肿瘤活性,但持久疗效及其在实体瘤中的广泛验证仍有待确立。

重要的是,应将iPSC-NK视为多种互补NK细胞平台之一,而非确定性或普遍优越的策略。总体而言,现有证据支持iPSC-NK作为有前景、可编程的现货型平台;但其最终临床影响将取决于能否实现可重复的大规模生产、平衡的基因工程设计,以及相对于其他NK细胞来源和成熟CAR-T 疗法具有稳定的体内表现。

展开英文摘要原文

In recent years, off-the-shelf cellular immunotherapies have attracted much attention as a practical alternative to autologous therapies. Within this landscape, induced pluripotent stem cell-derived natural killer cells (iPSC-derived NK cells; iPSC-NK) have emerged as a highly versatile platform because they combine renewable starting material, batch-to-batch uniformity, favorable intrinsic safety, and amenability to precise genetic engineering.

This review places iPSC-NK cells within the broader field of NK cell-based immunotherapy by comparing them with peripheral blood-derived NK cells, umbilical cord blood-derived NK cells, and NK cell lines, including clinically explored NK-92-based platforms, and by outlining key distinctions between NK cell therapies and CAR-T approaches.

We summarize current strategies for iPSC-to-NK differentiation, spanning feeder-based systems, feeder-free protocols, embryoid body approaches, and scalable GMP-compatible manufacturing methods.

We further discuss genetic engineering strategies for NK cells, with particular emphasis on genetic tuning as a systems-level framework for coordinating CAR signaling, cytokine responsiveness, and activation-inhibition balance to improve antitumor efficacy while preserving functional stability and clinical safety.

In addition, this review examines translational challenges that continue to limit broader NK-cell adoption, including incomplete functional maturation, limited persistence, donor- and source-dependent variability, manufacturing standardization, cryopreservation, and quality-control requirements. Early clinical studies of iPSC-NK products indicate a favorable safety profile and preliminary antitumor activity in selected hematologic malignancies, although durable efficacy and broader validation in solid tumors remain to be established.

Importantly, iPSC-NK cells should be considered one of several complementary NK-cell platforms rather than a definitive or universally superior strategy.

Overall, current evidence supports iPSC-NK cells as a promising programmable off-the-shelf platform, but their ultimate clinical impact will depend on achieving reproducible large-scale manufacturing, balanced genetic engineering, and consistent in vivo performance relative to other NK-cell sources and established CAR-T therapies.

论文信息

作者
Manshadi SM、Mehravar M、Hajifathali A、Roshandel E、Kaviani Jabali S
第一作者单位
Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran.Iran
通讯作者单位
Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. kavianis@modares.ac.ir.Iran
文献类型
综述
期刊
Stem cell reviews and reports2026 Aug
原文标识
PubMed 42189488 · DOI 10.1007/s12015-026-11156-y