Cell Stem Cell:比CAR-T更安全!CAR-NK疗法初显成效

2018-07-03 艾曼 生物探索

2017年,美国FDA先后批准两款CAR-T细胞疗法,推进了这一代表性免疫疗法的快速发展。除了“小车”CAR(嵌合抗原受体)的选择之外,科学家们开始思考免疫细胞的获得。最新一项研究提出一种可能:利用人类诱导性多能干细胞(iPSCs)获得的自然杀伤细胞(NK)经过类似的修饰之后,同样可以呈现出高效的抗癌活性。

6月28日,《Cell Stem Cell》期刊发表了这一最新研究,来自于加州大学圣地亚哥分校医学院和明尼苏达大学的科学家们合作发现,基于iPSCs获得的CAR-NK细胞可能比T细胞更有明显的优势。

免疫治疗的主要挑战之一是改良细胞的临床培育。我们已经证明,可以改造iPSCs,分化出表达有嵌合抗原受体(CAR)的NK细胞,从而更好地对抗难以治疗的癌症。”文章通讯作者、加州大学圣地亚哥分校细胞治疗部门负责人Dan S. Kaufman解释道。

近年来,基于CAR-T细胞的免疫疗法受到了广泛的关注和投资。作为一种“活的”药物,CAR-T疗法与传统药物有着很大的区别。首先,该疗法需要从患者体内分离出T细胞,在体外利用嵌合抗原受体(CAR)修饰T细胞,使其能够特异性识别癌细胞,然后再将改造后的T细胞扩增、回输至患者体内。

尽管CAR-T疗法已经展现出潜力,但是有明显的局限性。首先,细胞必须分离出体外(这一过程耗时长且费用高)。此外,由于T细胞是只针对特定患者进行修改,但是一些患者可能无法采集T细胞,或者没有足够的时间等待T细胞的准备过程。这些局限性可能会导致一些有望受益的患者无法接受CAR-T疗法。

此外,CAR-T疗法存在严重的毒性或副作用,包括细胞因子释放综合征CRS、神经毒性等。Kaufman之前的研究表明,NK细胞不会引发类似的毒性反应,而且在最新的研究中,他们以患癌小鼠为模型证实,NK细胞治疗几乎没有副作用。

“NK细胞有很多显着的优势,因为它不需要与特定病人进行匹配。此外,由iPSCs分化而来的NK细胞可以达到批量化,从而治疗更多的患者。这意味着,我们可以实现细胞治疗的标准化。”Kaufman说。

在他们的研究中,科学家们构建了卵巢癌异种移植小鼠模型,用于检测来源于人类iPSCs的CAR-NK细胞,并将其抗肿瘤活性与其他版本的NK细胞以及CAR-T细胞进行对比。结果发现,来源于人类iPSCs的CAR-NK细胞表现出与CAR-T细胞类似的抗癌活性,但是毒副作用相较小。

结果显示,卵巢癌是一个很好的尝试。Kaufman表示:“使用NK细胞可能更安全。”他正与总部位于圣地亚哥的Fate Therapeutics公司的科学家们合作,以推进临床试验的开展。未来,他们将继续在乳腺癌、脑瘤等实体瘤以及白血病等血液癌中验证来源于iPSCs的CAR-NK细胞的可行性。

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    2018-10-23 仁心济世
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    2018-10-01 维他命
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现如今,CAR-T在血液肿瘤乃至某些实体瘤上的成功和不俗表现大家都早已耳熟能详,随着两款CAR-T细胞药物的获批上市,这一领域已然热到滚烫,迅速成为了生物医药领域的重点突破方向,但关于CAR-T疗法的毒性作用也一直如鲠在喉。

对抗恶性淋巴瘤 CAR-T技术表现不俗

52岁的王女士,2015年7月中旬因腋窝肿物来到我院外科就诊,自述2个月前无意中发现双侧腋窝肿块,约花生米大小,无疼痛及不适感,也没有发热,但近来肿块逐渐增大至蛋黄一般。医生给予淋巴结穿刺活检检测,病理结果显示“弥漫大B细胞淋巴瘤”(非生发中心免疫表型),患者恐惧外科手术,遂出院回家调养。