CART

CART
  • 文章类型: Journal Article
    胶质母细胞瘤,一种高度恶性的颅内肿瘤,治疗进展缓慢。先前涉及靶向治疗和免疫检查点抑制剂的临床试验显示在治疗胶质母细胞瘤中没有显著益处。这种无效性主要是由于胶质母细胞瘤的复杂免疫抑制环境。胶质母细胞瘤细胞具有较低的免疫原性和较强的异质性,免疫微环境中充斥着抑制性细胞因子,许多免疫抑制细胞,有效T细胞不足。幸运的是,最近CART治疗胶质母细胞瘤的I期临床试验证实了其安全性,一小部分患者获得了生存益处。然而,CART治疗继续面临挑战,包括血脑屏障阻塞,抗原损失,和免疫抑制肿瘤微环境(TME)。本文提供了胶质母细胞瘤的免疫微环境的详细检查,来自内在和外在的肿瘤细胞因子,回顾当前多靶点CART治疗的临床和基础研究,最后概述了使用CART细胞治疗胶质母细胞瘤的关键挑战。
    Glioblastoma, a highly malignant intracranial tumor, has acquired slow progress in treatment. Previous clinical trials involving targeted therapy and immune checkpoint inhibitors have shown no significant benefits in treating glioblastoma. This ineffectiveness is largely due to the complex immunosuppressive environment of glioblastoma. Glioblastoma cells exhibit low immunogenicity and strong heterogeneity and the immune microenvironment is replete with inhibitory cytokines, numerous immunosuppressive cells, and insufficient effective T cells. Fortunately, recent Phase I clinical trials of CART therapy for glioblastoma have confirmed its safety, with a small subset of patients achieving survival benefits. However, CART therapy continues to face challenges, including blood-brain barrier obstruction, antigen loss, and an immunosuppressive tumor microenvironment (TME). This article provides a detailed examination of glioblastoma\'s immune microenvironment, both from intrinsic and extrinsic tumor cell factors, reviews current clinical and basic research on multi-targets CART treatment, and concludes by outlining the key challenges in using CART cells for glioblastoma therapy.
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  • 文章类型: Journal Article
    自从1980年代确认第一位感染人类免疫缺陷病毒(HIV)的患者以来,发现HIV疗法的努力一直在继续。十年后,第一种艾滋病毒药物,齐多夫定(AZT),靶向HIV逆转录酶,已开发。同时,科学家们被启发发现了针对不同HIV基因的新药,像整合酶,蛋白酶,和宿主受体。联合抗逆转录病毒疗法(cART)是抑制HIV感染者(PWH)病毒和控制流行的最可行的医学干预措施。ART治疗使HIV成为一种慢性感染而不是致命疾病,但是ART并不能从宿主细胞中消除HIV-1的潜在储库;为了使治疗对患者有效,需要严格和终身坚持ART。在这次审查中,我们首先讨论了传统HIV药物发现的科学史,因为科学家需要开发越来越多的药物来解决耐药问题并释放副作用。然后,我们总结了新的研究技术,比如基因编辑,应用于艾滋病毒治疗及其作为补充疗法对消除艾滋病毒的贡献。
    The efforts to discover HIV therapeutics have continued since the first human immunodeficiency virus (HIV) infected patient was confirmed in the 1980s. Ten years later, the first HIV drug, zidovudine (AZT), targeting HIV reverse transcriptase, was developed. Meanwhile, scientists were enlightened to discover new drugs that target different HIV genes, like integrase, protease, and host receptors. Combination antiretroviral therapy (cART) is the most feasible medical intervention to suppress the virus in people with HIV (PWH) and control the epidemic. ART treatment has made HIV a chronic infection rather than a fatal disease, but ART does not eliminate latent reservoirs of HIV-1 from the host cells; strict and life-long adherence to ART is required for the therapy to be effective in patients. In this review, we first discussed the scientific history of conventional HIV drug discovery since scientists need to develop more and more drugs to solve drug-resistant issues and release the side effects. Then, we summarized the novel research technologies, like gene editing, applied to HIV treatment and their contributions to eliminating HIV as a complementary therapy.
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  • 文章类型: Journal Article
    当前的研究分析了交叉的生物物理,生物化学,和具有人类免疫缺陷病毒1型(HIV-1)的细胞外颗粒(EP)的功能特性超出了HIV-1目前接受的大小范围。我们通过顺序差异超速离心(DUC)从HIV感染的细胞中分离出五个级分(Frac-A至Frac-E)。所有的级分均表现出不均匀的粒度分布,Frac-A至Frac-D的中值粒度大于100nm,但Frac-E的中值粒度不大于100nm。其含有平均尺寸远低于50nm的小EP。同步和释放的培养物在Frac-A中含有大量的传染性EP,具有两性体和病毒成分的标记。此外,Frac-E独特地含有对CD63、HSP70和HIV-1蛋白呈阳性的EPs。尽管它的平均尺寸很小,Frac-E含有膜保护的病毒整合酶,只有在SDS处理后才能检测到,表明它被囊泡包围。使用dSTORM的单颗粒分析进一步支持了这些发现,如CD63,HIV-1整合酶,和病毒表面包膜(Env)糖蛋白(gp)共定位在相同的Frac-E颗粒上。令人惊讶的是,Frac-EEP具有传染性,通过用抗CD63免疫消耗Frac-E,感染性显着降低,表明该蛋白存在于Frac-E中的感染性小EP表面。据我们所知,这是细胞外囊泡(EV)分离方法首次鉴定出50nm以下的感染性小HIV-1颗粒(smHIV-1)。总的来说,我们的数据表明,EP和HIV-1之间的交叉点可能超出了目前公认的HIV-1的生物物理特性,这可能对病毒的发病机制有进一步的影响.
    The current study analyzed the intersecting biophysical, biochemical, and functional properties of extracellular particles (EPs) with the human immunodeficiency virus type-1 (HIV-1) beyond the currently accepted size range for HIV-1. We isolated five fractions (Frac-A through Frac-E) from HIV-infected cells by sequential differential ultracentrifugation (DUC). All fractions showed a heterogeneous size distribution with median particle sizes greater than 100 nm for Frac-A through Frac-D but not for Frac-E, which contained small EPs with an average size well below 50 nm. Synchronized and released cultures contained large infectious EPs in Frac-A, with markers of amphisomes and viral components. Additionally, Frac-E uniquely contained EPs positive for CD63, HSP70, and HIV-1 proteins. Despite its small average size, Frac-E contained membrane-protected viral integrase, detectable only after SDS treatment, indicating that it is enclosed in vesicles. Single particle analysis with dSTORM further supported these findings as CD63, HIV-1 integrase, and the viral surface envelope (Env) glycoprotein (gp) colocalized on the same Frac-E particles. Surprisingly, Frac-E EPs were infectious, and infectivity was significantly reduced by immunodepleting Frac-E with anti-CD63, indicating the presence of this protein on the surface of infectious small EPs in Frac-E. To our knowledge, this is the first time that extracellular vesicle (EV) isolation methods have identified infectious small HIV-1 particles (smHIV-1) that are under 50 nm. Collectively, our data indicate that the crossroads between EPs and HIV-1 potentially extend beyond the currently accepted biophysical properties of HIV-1, which may have further implications for viral pathogenesis.
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  • 文章类型: Journal Article
    心肌缺血再灌注损伤(MIRI)是在急性心肌梗死再灌注治疗的背景下发生的常见临床情况。研究表明,可卡因和苯丙胺调节转录物(CART)可以改善脑缺血再灌注(I/R)损伤,但尚未研究CART对MIRI的影响。这里,我们发现CART在I/R过程中通过抑制细胞凋亡和过度自噬来保护心脏,表明CART将是治疗MIRI的潜在候选药物。进一步分析显示CART上调了磷酸-AKT的活化,导致乳酸脱氢酶(LDH)释放下调,凋亡,I/R后氧化应激和过度自噬,被PI3K抑制剂抑制,LY294002.总的来说,CART通过抑制心肌细胞凋亡和过度自噬来减弱MIRI,保护作用依赖于PI3K/AKT信号通路。
    Myocardial ischemia-reperfusion injury (MIRI) is a common clinic scenario that occurs in the context of reperfusion therapy for acute myocardial infarction. It has been shown that cocaine and amphetamine-regulated transcript (CART) can ameliorate cerebral ischemia-reperfusion (I/R) injury, but the effect of CART on MIRI has not been studied yet. Here, we revealed that CART protected the heart during I/R process by inhibiting apoptosis and excessive autophagy, indicating that CART would be a potential drug candidate for the treatment of MIRI. Further analysis showed that CART upregulated the activation of phospho-AKT, leading to downregulation of lactate dehydrogenase (LDH) release, apoptosis, oxidative stress and excessive autophagy after I/R, which was inhibited by PI3K inhibitor, LY294002. Collectively, CART attenuated MIRI through inhibition of cardiomyocytes apoptosis and excessive autophagy, and the protective effect was dependent on PI3K/AKT signalling pathway.
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  • 文章类型: Journal Article
    癌症治疗有丰富的历史,为当前和未来的癌症治疗提供了许多重要的经验。我们回顾过去,勾勒出这段历史,回顾癌症治疗的现状,通过浏览潜在的未来癌症疗法。
    There is a rich history of cancer treatments which provides a number of important lessons for present and future cancer therapies. We outline this history by looking in the past, reviewing the current landscape of cancer treatments, and by glancing at the potential future cancer therapies.
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  • 文章类型: Journal Article
    表达嵌合抗原受体(CAR)的工程化T细胞对血液恶性肿瘤显示出显著的治疗效果。然而,CART细胞对实体瘤的疗效较差,主要是由于它们的持久性较弱,这可能是由激活诱导的细胞死亡(AICD)引起的。为了克服这个限制,带有抗原的CART细胞,表皮生长因子受体变体III(EGFRvIII),靶向被修饰为携带抗凋亡分子B细胞淋巴瘤2(Bcl-2),最终构建体命名为EGFRvIII·CART-Bcl2细胞。与EGFRvIII·CART细胞相比,EGFRvIII·CART-Bcl2细胞显示出更高的增殖能力,体外抗凋亡和肿瘤细胞杀伤。此外,EGFRvIII·CART-Bcl2细胞比EGFRvIII·CART细胞在宫颈癌异种移植模型中具有更长的存留率和更好的抗肿瘤作用。一起来看,我们的研究结果表明,在CART细胞中掺入抗凋亡分子可能增强其对实体瘤的治疗效果.
    Engineered T cells expressing chimeric antigen receptors (CARs) have shown remarkable therapeutic effects on haematological malignancies. However, CART cells are less effective on solid tumours mainly due to their weak persistence, which might be caused by activation-induced cell death (AICD). To overcome this limitation, CART cell with the antigen, Epidermal growth factor receptor variant III (EGFRvIII), targeting was modified to carry the anti-apoptotic molecule B cell lymphoma 2 (Bcl-2), and the final construct was named as EGFRvIII·CART-Bcl2 cells. Compared with the EGFRvIII·CART cells, EGFRvIII·CART-Bcl2 cells revealed higher capacities of proliferation, anti-apoptosis and tumour cell killing in vitro. Moreover, EGFRvIII·CART-Bcl2 cells had a longer persistence rate and exerted better anti-tumour effects than EGFRvIII·CART cells in cervical carcinoma xenograft model. Taken together, our findings suggest that incorporating anti-apoptotic molecules into CART cells may enhance its therapeutic effects against solid tumours.
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  • 文章类型: Journal Article
    背景:接受造血细胞移植(HCT)或嵌合抗原受体(CAR)T细胞治疗的血液恶性肿瘤患者在出院后有发生严重临床并发症的风险。
    目的:TEL-HEMATO研究的目的是改善我们的远程医疗平台,以便在出院后的前3个月内对接受HCT或CAR-T细胞治疗的患者进行随访。
    方法:从2022年11月至2023年7月,筛选了11例接受自体(n=2)或同种异体(n=5)HCT或CAR-T细胞治疗(n=4)的血液系统恶性肿瘤患者。两名患者在入组后停止研究。远程医疗平台包括每天收集生命体征,身体症状,出院后3个月的生活质量评估。每位患者都接受了经过临床验证的智能手表(ScanWatch)和数字温度计,一个专门的智能手机应用程序被用来收集这些数据。血液学家或专业从事HCT和CAR-T细胞治疗的护士通过基于网络的平台对数据进行每日修订。
    结果:成功收集了通过ScanWatch测量的生命体征,并具有中/高依从性:记录了8/9(89%)患者的心率,记录9/9(100%)患者的氧饱和度和每日步数,并记录了7/9(78%)患者的睡眠时间。然而,患者手动记录的体温与较低的依从性有关,在5/9(55%)患者中记录。总的来说,5/9(55%)患者在应用程序中报告了临床症状。8/9(89%)的患者在纳入研究时完成了生活质量评估,在第三个月末下降到3/9(33%)。通过系统可用性量表上提供的评级,可用性被认为是可以接受的。然而,患者报告了技术问题。
    结论:虽然将可穿戴设备添加到远程医疗临床平台可能对HCT和CAR-T细胞治疗患者监测具有潜在的协同益处,平台的非完全自动化和缺乏专门的远程医疗团队仍然是需要克服的主要限制.在我们的现实生活中尤其如此,目标人群通常包括数字教育水平较低的老年患者。
    BACKGROUND: Patients with hematological malignancies receiving hematopoietic cell transplantation (HCT) or chimeric antigen receptor (CAR) T-cell therapy are at risk of developing serious clinical complications after discharge.
    OBJECTIVE: The aim of the TEL-HEMATO study was to improve our telehealth platform for the follow-up of patients undergoing HCT or CAR T-cell therapy during the first 3 months after discharge with the addition of wearable devices.
    METHODS: Eleven patients who received autologous (n=2) or allogeneic (n=5) HCT or CAR T-cell therapy (n=4) for hematological malignancies were screened from November 2022 to July 2023. Two patients discontinued the study after enrollment. The telehealth platform consisted of the daily collection of vital signs, physical symptoms, and quality of life assessment up to 3 months after hospital discharge. Each patient received a clinically validated smartwatch (ScanWatch) and a digital thermometer, and a dedicated smartphone app was used to collect these data. Daily revision of the data was performed through a web-based platform by a hematologist or a nurse specialized in HCT and CAR T-cell therapy.
    RESULTS: Vital signs measured through ScanWatch were successfully collected with medium/high adherence: heart rate was recorded in 8/9 (89%) patients, oxygen saturation and daily steps were recorded in 9/9 (100%) patients, and sleeping hours were recorded in 7/9 (78%) patients. However, temperature recorded manually by the patients was associated with lower compliance, which was recorded in 5/9 (55%) patients. Overall, 5/9 (55%) patients reported clinical symptoms in the app. Quality of life assessment was completed by 8/9 (89%) patients at study enrollment, which decreased to 3/9 (33%) at the end of the third month. Usability was considered acceptable through ratings provided on the System Usability Scale. However, technological issues were reported by the patients.
    CONCLUSIONS: While the addition of wearable devices to a telehealth clinical platform could have potentially synergic benefits for HCT and CAR T-cell therapy patient monitoring, noncomplete automation of the platform and the absence of a dedicated telemedicine team still represent major limitations to be overcome. This is especially true in our real-life setting where the target population generally comprises patients of older age with a low digital education level.
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  • 文章类型: Journal Article
    加强社区抗灾能力建设,减少灾害影响已提上中国政府的议事日程。COVID-19大流行可能会改变现有的社区抵御能力。本研究旨在探讨中国社区复原力的动态变化趋势,分析COVID-19背景下社区复原力的主要影响因素,构建中国社区复原力治理体系框架。
    使用社区进步弹性工具包(CART)在广东进行调查,四川,2015年和2022年,收集了社区复原力数据以及居民灾害风险意识和减少灾害风险行为的信息。收集来自政府机构和社区工作人员(n=15)的定性(深度访谈)数据,以探索中国的社区弹性治理体系框架。采用描述性统计分析和t检验对我国社区韧性的动态发展进行了研究。采用性别、年龄等社会人口学特征进行分层回归分析,探讨居民社区韧性的主要影响因素。
    结果表明,中国的社区复原力明显提高,差异具有统计学意义(p<0.05)。在2015年,连接和关怀取得了最高分,而灾害管理在2022年取得了最高分,资源和变革潜力在这两年的得分中排名最低。一般来说,居民对灾害风险有很高的认识。然而,只有一小部分被调查的居民参加了任何“社区组织的流行病预防和控制志愿服务”(34.9%)。分析表明,社区复原力的核心影响因素包括:对主要疫情相关信息的高度敏感性,特别注意各种防疫预警信息,参与防疫志愿服务,并制定流行病应对计划。在这项研究中,构建了我国社区韧性治理体系框架,其中包括社区韧性风险意识,社区复原力治理机构,社区复原机制和系统。
    在大流行期间,中国的社区复原力发生了重大变化。然而,社区资本是,是,并将成为社区复原力的薄弱环节。建议进一步对社区复原力动态变化趋势进行多阶段评估,分析不同阶段社区复原力建立的作用点和核心影响因素。
    Strengthening the construction of community resilience and reducing disaster impacts are on the agenda of the Chinese government. The COVID-19 pandemic could alter the existing community resilience. This study aims to explore the dynamic change trends of community resilience in China and analyze the primary influencing factors of community resilience in the context of COVID-19, as well as construct Community Resilience Governance System Framework in China.
    A community advancing resilience toolkit (CART) was used to conduct surveys in Guangdong, Sichuan, and Heilongjiang provinces in China in 2015 and 2022, with community resilience data and information on disaster risk awareness and disaster risk reduction behaviors of residents collected. The qualitative (in-depth interview) data from staffs of government agencies and communities (n = 15) were pooled to explore Community Resilience Governance System Framework in China. Descriptive statistics analysis and t-tests were used to investigate the dynamic development of community resilience in China. Hierarchical regression analysis was performed to explore the main influencing factors of residential community resilience with such socio-demographic characteristics as gender and age being controlled.
    The results indicate that community resilience in China has improved significantly, presenting differences with statistical significance (p < 0.05). In 2015, connection and caring achieved the highest score, while disaster management achieved the highest score in 2022, with resources and transformative potential ranking the lowest in their scores in both years. Generally, residents presented a high awareness of disaster risks. However, only a small proportion of residents that were surveyed had participated in any \"community-organized epidemic prevention and control voluntary services\" (34.9%). Analysis shows that core influencing factors of community resilience include: High sensitivity towards major epidemic-related information, particular attention to various kinds of epidemic prevention and control warning messages, participation in epidemic prevention and control voluntary services, and formulation of epidemic response plans. In this study, we have constructed Community Resilience Governance System Framework in China, which included community resilience risk awareness, community resilience governance bodies, community resilience mechanisms and systems.
    During the pandemic, community resilience in China underwent significant changes. However, community capital was, is, and will be a weak link to community resilience. It is suggested that multi-stages assessments of dynamic change trends of community resilience should be further performed to analyze acting points and core influencing factors of community resilience establishment at different stages.
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  • 文章类型: Journal Article
    Pou6f2是小鼠中央角膜厚度(CCT)与发生原发性开角型青光眼的危险因素之间的遗传联系。POU6F2也是人类多种疾病的危险因素,包括青光眼,近视,和诵读困难.最近的发现表明POU6F2阳性视网膜神经节细胞(RGC)在小鼠中包含许多RGC亚型,其中一些还共染色Cdh6和Hoxd10。这些POU6F2阳性RGC似乎是不与CART或SATB2(典型的ooDSGC标记)共染色的开-关定向选择性神经节细胞(ooDSGC)的新型细胞。这些P0U6F2阳性细胞对由升高的眼内压引起的损伤敏感。在DBA/2J小鼠青光眼模型中,重度标记的POU6F2RGC在8月龄时减少了73%,而总RGC仅减少了22%(用RBPMS标记).此外,Pou6f2-/-小鼠遭受敏度和空间对比敏感度的显著损失以及总RGC的11.4%损失。在恒河猴的视网膜上,POU6F2标记形成大细胞(M)途径的大型阳伞神经节细胞。POU6F2与M途径的关联可能部分揭示了其在人类青光眼中的作用。近视,和诵读困难.
    Pou6f2 is a genetic connection between central corneal thickness (CCT) in the mouse and a risk factor for developing primary open-angle glaucoma. POU6F2 is also a risk factor for several conditions in humans, including glaucoma, myopia, and dyslexia. Recent findings demonstrate that POU6F2-positive retinal ganglion cells (RGCs) comprise a number of RGC subtypes in the mouse, some of which also co-stain for Cdh6 and Hoxd10. These POU6F2-positive RGCs appear to be novel of ON-OFF directionally selective ganglion cells (ooDSGCs) that do not co-stain with CART or SATB2 (typical ooDSGCs markers). These POU6F2-positive cells are sensitive to damage caused by elevated intraocular pressure. In the DBA/2J mouse glaucoma model, heavily-labeled POU6F2 RGCs decrease by 73% at 8 months of age compared to only 22% loss of total RGCs (labeled with RBPMS). Additionally, Pou6f2-/- mice suffer a significant loss of acuity and spatial contrast sensitivity along with an 11.4% loss of total RGCs. In the rhesus macaque retina, POU6F2 labels the large parasol ganglion cells that form the magnocellular (M) pathway. The association of POU6F2 with the M-pathway may reveal in part its role in human glaucoma, myopia, and dyslexia.
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  • 文章类型: Journal Article
    在这篇综述中,我们总结了目前描述复发/难治性MCL患者管理的证据,并概述了过去二十年来开发的各种新疗法。我们还描述了总体反应率,完全反应率,响应的持续时间,随着新疗法的引入,预期寿命急剧增加,特别是共价布鲁顿酪氨酸激酶抑制剂(BTKi)和嵌合抗原受体T细胞(CAR-T)治疗。BTKi或CAR-T后进行性疾病患者的最新新兴选择,包括非共价BTKi,抗体-药物缀合物,Bcl-2抑制剂,和双特异性抗体,可以进一步提高应答率和结果。未来的方向应该集中在确定最佳测序和/或越来越多可用的治疗选择的组合,同时优先考虑具有治愈潜力的策略。
    In this review we summarize the current evidence describing the management of patients with relapsed/refractory MCL and outline the various novel therapeutics that have been developed over the past two decades. We also describe how overall response rates, complete response rates, duration of responses, and life expectancy have dramatically increased with the introduction of novel therapies, particularly covalent Bruton Tyrosine Kinase inhibitors (BTKi) and chimeric antigen receptor T-cell (CAR-T) therapy. The most recent emerging options for patients with progressive disease following BTKi or CAR-T, including non-covalent BTKi, antibody-drug conjugates, Bcl-2 inhibitors, and bispecific antibodies, may further improve response rates and outcomes. Future directions should focus on identifying the best sequencing and/or combinations of the increasingly available treatment options while prioritizing strategies with curative potential.
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