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:Chromosomal Instability Drives Glioblastoma Heterogeneity and Therapeutic Opportunities.
Chromosomal Instability Drives Glioblastoma Heterogeneity and Therapeutic Opportunities.
胶质母细胞瘤是侵袭性最强、最致命的一种脑癌,以显著的基因组不稳定性为特征,其中染色体不稳定性(CIN)在驱动肿瘤进展、治疗耐药和不良预后中发挥核心作用。
胶质母细胞瘤是最具侵袭性和致死性的脑癌,其显著基因组不稳定性中,染色体不稳定性(CIN)在推动肿瘤进展、治疗耐药及不良预后方面发挥核心作用。CIN以染色体数目和结构改变为特征,由有丝分裂错误、中心体扩增、纺锤体组装检查点功能障碍及DNA修复通路缺陷等机制驱动。这些异常增加肿瘤异质性,促使具有更强可塑性、治疗耐药性和转移能力的胶质母细胞瘤干细胞(GSC)出现。染色体灾变(chromothripsis)常涉及特定染色体,由微核破裂引起并导致染色体重排。CIN的免疫学影响同样重要:环鸟苷酸-腺苷酸合成酶-干扰素基因刺激因子(cGAS-STING)通路可在抗肿瘤免疫与免疫逃逸之间发挥双向作用。研究者正在探索靶向CIN的治疗策略,包括中心体聚集抑制剂、DNA损伤应答通路及纺锤体组分抑制剂,以及CAR-T(CAR-T)细胞疗法和纳米颗粒药物递送等创新方法。单细胞测序进展为理解CIN驱动的胶质母细胞瘤异质性及治疗脆弱性带来变革性认识。通过整合机制理解与转化策略,本综述强调CIN既是治疗挑战也是潜在机遇,并为改善胶质母细胞瘤治疗结局和患者生存指明方向。
Glioblastoma, the most aggressive and lethal form of brain cancer, is defined by profound genomic instability, with Chromosomal Instability (CIN) playing a central role in driving tumor progression, therapy resistance, and poor prognosis. CIN is characterized by numerical and structural alterations, is driven by mechanisms such as mitotic errors, centrosome amplification, spindle assembly checkpoint dysfunction, and defective DNA repair pathways. These aberrations contribute to tumor heterogeneity, leading to the emergence of Glioblastoma Stem Cells (GSCs) with enhanced plasticity, therapy resistance, and metastatic capacity. Chromothripsis, frequently involves specific chromosomes and stems from micronuclei rapture, resulting in chromosomal rearrangement. The immune implications of CIN are also critical, with the Cyclic GMP-AMP Synthase-Stimulator of Interferon Genes (cGAS-STING) pathway toggling between anti-tumor immunity and immune evasion. Therapeutic strategies targeting CIN are explored, including inhibitors of centrosomal clustering, DNA damage response pathways, and spindle assembly components, as well as innovative approaches like Chimeric Antigen Receptor T (CAR-T) cell therapies and nanoparticle-based drug delivery systems. Advances in single-cell sequencing provide transformative insights into CIN-driven glioblastoma heterogeneity and therapeutic vulnerabilities. By integrating mechanistic understanding with translational strategies, this review underscores CIN as both a therapeutic challenge and an opportunity, charting a path toward improving glioblastoma treatment outcomes and patient survival.
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