靶向巨噬细胞的癌症治疗策略
Macrophage-directed therapeutic strategies in cancer.
肿瘤相关巨噬细胞(TAMs)是肿瘤微环境的主要组成部分,具有显著的功能可塑性,根据所处的微环境信号,既可表现为促进肿瘤进展的免疫抑制细胞,也可表现为支持抗肿瘤免疫的免疫刺激细胞。
英文原题:Checkpoint inhibition and beyond: Precision immune engineering for the immune-privileged landscape of ocular malignancies.
眼部恶性肿瘤,尤其是葡萄膜黑色素瘤和结膜黑色素瘤,正是肿瘤在人体免疫学限制最严苛的生态系统之一——眼部的免疫豁免微环境——中演进的典型例证。
眼部恶性肿瘤,尤其葡萄膜黑色素瘤和结膜黑色素瘤,是在人体免疫限制最严格的生态环境之一——眼部免疫豁免微环境中演化的肿瘤。PD-1/PD-L1和CTLA-4阻断在这些癌症中的疗效有限,凸显了从线性免疫检查点抑制转向多维免疫工程的必要性。本综述结合合成生物纳米技术、人工智能引导的免疫基因组学及空间免疫组学,重新审视眼部免疫治疗,并重新界定如何在眼组织内程序化调控免疫耐受与免疫应答。我们总结双特异性T细胞衔接器、溶瘤病毒免疫疗法、mRNA及树突状细胞疫苗,以及工程化CAR/TCR-T平台的最新进展,阐述这些方法如何协同将眼部肿瘤微环境由免疫沉默转变为免疫应答状态。逻辑门控抗体、活性氧(ROS)响应型纳米载体及CRISPR辅助的检查点重编程,进一步拓展了“精准免疫工程”的概念。这些进展旨在暂时改变免疫豁免状态,同时不损害视觉质量。最后,我们提出眼部肿瘤免疫学2.0的系统层级模型:免疫豁免并非不可改变的屏障,而是可配置的治疗调控回路。动态闭环免疫工程架构的组成要素之一是免疫检查点抑制。通过结合AI驱动的新抗原检测、液体活检反馈回路及灵活递送生物材料,该平台有望实现持久且保留视力的疾病治疗。尽管其中若干方法仍处于概念阶段或早期转化阶段,但它们为眼部肿瘤学中保留视力的免疫治疗描绘了可行路线图。
Ocular malignancies, particularly uveal and conjunctival melanoma, exemplify tumors that evolve within one of the body's most immunologically constrained ecosystems, the eye's immune-privileged microenvironment. The limited success of PD-1/PD-L1 and CTLA-4 blockade in these cancers underscores the need to move beyond linear checkpoint inhibition toward multidimensional immune engineering. Through the confluence of synthetic bio-nanotechnology, AI-guided immunogenomics, and spatial immunomics, this review reframes ocular immunotherapy and redefines how tolerance and immunity might be programmatically regulated within ocular tissue. We synthesize recent advances in bispecific T-cell engagers, oncolytic viro-immunotherapy, mRNA and dendritic-cell vaccines, and engineered CAR/TCR-T platforms, highlighting how they collectively reconfigure the ocular tumor microenvironment from immune-silent to immune-responsive. Logic-gated antibodies, ROS-responsive nanocarriers, and CRISPR-assisted checkpoint reprogramming are added to the notion of "precision immune engineering". These developments are intended to temporarily alter immune privilege without sacrificing visual quality. Lastly, we suggest a systems-level model for ocular immuno-oncology 2.0, where immune privilege is not an unchangeable barrier but rather a configurable circuit for therapeutic orchestration. One element of a dynamic, closed-loop immune-engineering architecture is checkpoint inhibition. This platform offers the possibility of long-lasting, vision-preserving disease treatment by combining AI-driven neoantigen detection, liquid-biopsy feedback loops, and flexible delivery biomaterials. While several of these approaches remain at a conceptual or early translational stage, they outline a plausible roadmap toward vision-preserving immunotherapy in ocular oncology.
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