Saraton kasalligini davolashda immunoterapiya
Cancer CAR-NK therapy has an effective rate of 73%, and is being recruited in domestic clinical trials.
Immunotherapy has revolutionized the way cancer is treated. Cancer immunotherapy is divided into two categories: one is immune checkpoint inhibitors, and PD-1, PD-L1 and CTLA-4 have been approved for the treatment of a variety of cancers. And the 2018 Nobel Prize in Physiology or Medicine awarded the contribution of the development of immune checkpoint inhibitors to humans.
Ikkinchisi hujayrali immunoterapiya bo'lib, unda chimeric antigen receptor CAR-T therapy is the most rapidly progressing one. In 2017, the US Food and Drug Administration (FDA) approved two CAR-T cell therapies, Yescarta and Kymriah, which mainly target hematological tumors, leukemias and limfomalar.
CAR T Uyali terapiya
CAR-T therapy has a long way to go to treat solid tumors, so scientists have begun to seek other cellular immunoterapiya to treat cancer, and natural killer (NK) cell therapy is one of the most promising methods. The success of CAR-T cell therapy has stimulated enthusiasm for modifying NK cells with CAR genes to enhance their tumor-killing ability.
Recently, the results of a phase I / IIa trial of the MD Anderson Cancer Center in the United States announced that CD19-targeted umbilical cord blood chimeric antigen receptor natural killer cell therapy (CAR-NK) has achieved a clinical response. No major toxicities were observed in patients with refractory or refractory Hodgkin bo'lmagan limfoma (NHL) and chronic lymphocytic leukemia (CLL).
CAR-NK hujayra terapiyasi tadqiqotlari
Sud natijalari kecha New England Journal of Medicine jurnalida e'lon qilindi. Tadqiqotda ishtirok etgan 11 bemorning 8 nafari (73%) davolanishga javob berishdi va ularning 7 nafari to'liq javob berishdi, ya'ni ular 13.8 oylik o'rtacha kuzatuvda saraton alomatlarini ko'rsatmaydilar va hech bir bemor hujayralarni boshdan kechirmagan. Faktor tarqalish sindromi yoki neyrotoksiklik.
CD19 CAR-NK hujayra terapiyasiga javob infuziondan keyin 1 oy ichida ahamiyatli bo'lib, infuziondan keyin 1 yil ichida ushbu hujayralarning davomiyligi aniqlandi.
Korrespondent muallif Katy Rezvani, Ildiz hujayralarini transplantatsiyasi va hujayra terapiyasi professori shunday dedi: "Bizni klinik tadqiqotlar natijalari rag'batlantiradi, ular allogenik ichakchasidagi qondan olingan CAR-NK hujayralarining potentsialini o'rganish bo'yicha keyingi klinik tadqiqotlar olib boradi. muhtoj bo'lgan bemorni davolash usullari. "
MD Anderson saraton markazida NK hujayralari donor qilingan kindik qonidan ajratilgan va saratonga xos maqsadlarni aniqlay oladigan zaruriy CARni ifodalash uchun genetik jihatdan ishlab chiqarilgan. CAR-NK hujayralari, shuningdek, hujayraning ko'payishi va omon qolish jarayonini kuchaytirishga mo'ljallangan immun-signalizatsiya molekulasi IL-15 bilan "jihozlangan" bo'lishi kerak.
Ushbu tadqiqotda CAR-NK hujayralari allogenikdir, ya'ni bu hujayralar bemorga emas, balki bemorga aloqasi bo'lmagan sog'lom donorlardan olinadi. Shuning uchun CAR-NK xujayralari darhol foydalanish uchun oldindan ishlab chiqarilishi va saqlanishi mumkin. Aksincha, hozirgi vaqtda sotilayotgan CAR-T hujayralari bemorning o'z genlari asosida genetik jihatdan yaratilgan T hujayralarini ishlab chiqarish uchun ko'p haftalik madaniyatni ko'paytirish jarayonidan foydalanishi kerak.
CAR-NK hujayralari CAR-T hujayralariga nisbatan bir qancha afzalliklarga ega
First, unlike CAR-T cells, CAR-NK cells retain the inherent ability to recognize and target shish cells through their natural receptors, so that when CAR-NK targeted therapy is used, tumor cells are less likely to escape killing.
Second, CAR-NK cells do not undergo immune rejection for days to weeks. As a result, they have not shown the same safety issues in many CAR-T clinical trials, such as the absence of sitokinlarni chiqarish sindromi.
Va nihoyat, NK hujayralari qattiq HLA mos kelishini talab qilmaydi va greftga qarshi xost kasalligini keltirib chiqarishi mumkin emas, bu CAR-T hujayra immunoterapiyasi uchun muhim xavf hisoblanadi.
