NK-cell therapy

  • 文章类型: Journal Article
    自然杀伤(NK)细胞,先天免疫系统的主要组成部分,有突出的免疫调节,抗肿瘤增殖,和抗病毒活性。NK细胞在神经系统自身免疫中起着双刃剑的作用,具有治疗潜力。新的证据已经确定NK细胞参与神经免疫疾病如多发性硬化症的发展和进展。视神经脊髓炎谱系障碍,自身免疫性脑炎,格林-巴利综合征,慢性炎症性脱髓鞘性多发性神经病,重症肌无力,和特发性炎性肌病.然而,NK细胞的调节机制和功能作用在不同临床状态下的神经免疫疾病中存在高度差异,需要进一步确定。在这次审查中,我们总结了在上述条件下NK细胞异源参与的证据。Further,我们描述了临床前和临床开发中针对神经免疫疾病的尖端NK细胞免疫治疗,并强调了必须克服的挑战,才能充分发挥NK细胞的治疗潜力.
    Natural killer (NK) cells, a major component of the innate immune system, have prominent immunoregulatory, antitumor proliferation, and antiviral activities. NK cells act as a double-edged sword with therapeutic potential in neurological autoimmunity. Emerging evidence has identified NK cells are involved in the development and progression of neuroimmunological diseases such as multiple sclerosis, neuromyelitis optica spectrum disorders, autoimmune encephalitis, Guillain-Barré Syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, and idiopathic inflammatory myopathy. However, the regulatory mechanisms and functional roles of NK cells are highly variable in different clinical states of neuroimmunological diseases and need to be further determined. In this review, we summarize the evidence for the heterogenic involvement of NK cells in the above conditions. Further, we describe cutting-edge NK-cell-based immunotherapy for neuroimmunological diseases in preclinical and clinical development and highlight challenges that must be overcome to fully realize the therapeutic potential of NK cells.
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  • 文章类型: Journal Article
    目的:为了加强癌症免疫细胞治疗的科学证据,并进一步检查其安全性,2015年10月,我院与全国39家医疗机构共同成立了肿瘤免疫细胞治疗评估小组(CITEG)。
    方法:医疗信息,如患者的背景特征,从每个设施获得的临床疗效和治疗细胞类型,已经积累,通过CITEG进行分析和评估。在这项前瞻性研究中,我们分析了截至2022年9月底与免疫细胞治疗相关的不良事件,并进行了中期安全性评估.
    结果:共3839例恶性肿瘤患者接受免疫细胞治疗,年龄中位数为64岁(范围,13-97岁),男女比例为1:1.08(1846:1993)。大多数患者首次就诊时的表现状态为0或1(86.8%),3234例(84.2%)为晚期或复发病例,占大多数。CITEG报告的给药总数为31890次,其中960次(3.0%)出现不良事件。在19661次αβT细胞治疗中,由治疗引起的不良事件的数量为363次(1.8%),845次施用γδT细胞疗法中的9次(1.1%)和626次施用自然杀伤细胞疗法中的10次(1.6%)。由树突状细胞(DC)疫苗治疗引起的不良事件数量为10748次给药中的578次(5.4%),明显大于其他治疗方法。多变量分析显示,αβT细胞治疗在表现状态1或更高的情况下发生不良事件的风险显著增加。和64岁以下的患者,女性或辅助免疫细胞治疗在DC疫苗治疗中发生不良事件的风险更大.注射部位反应是最常见的不良事件。449个事件,其中大部分与DC疫苗治疗相关.在所有其他不良事件中,发烧(228个事件),我们经常报告疲劳(141例)和瘙痒(131例).相比之下,三名患者出现不良事件(发烧,腹痛和间质性肺炎)需要住院治疗,尽管它们与这种疗法的联系较弱;相反,它被认为是治疗原发性疾病的效果。
    结论:癌症的免疫细胞疗法被认为是一种安全的治疗方法,没有严重的不良事件。
    With the aim of strengthening the scientific evidence of immune-cell therapy for cancer and further examining its safety, in October 2015, our hospital jointly established the Cancer Immune-Cell Therapy Evaluation Group (CITEG) with 39 medical facilities nationwide.
    Medical information, such as patients\' background characteristics, clinical efficacy and therapeutic cell types obtained from each facility, has been accumulated, analyzed and evaluated by CITEG. In this prospective study, we analyzed the adverse events associated with immune-cell therapy until the end of September 2022, and we presented our interim safety evaluation.
    A total of 3839 patients with malignant tumor were treated with immune-cell therapy, with a median age of 64 years (range, 13-97 years) and a male-to-female ratio of 1:1.08 (1846:1993). Most patients\' performance status was 0 or 1 (86.8%) at the first visit, and 3234 cases (84.2%) were advanced or recurrent cases, which accounted for the majority. The total number of administrations reported in CITEG was 31890, of which 960 (3.0%) showed adverse events. The numbers of adverse events caused by treatment were 363 (1.8%) of 19661 administrations of αβT cell therapy, 9 of 845 administrations of γδT-cell therapy (1.1%) and 10 of 626 administrations of natural killer cell therapy (1.6%). The number of adverse events caused by dendritic cell (DC) vaccine therapy was 578 of 10748 administrations (5.4%), which was significantly larger than those for other treatments. Multivariate analysis revealed that αβT cell therapy had a significantly greater risk of adverse events at performance status 1 or higher, and patients younger than 64 years, women or adjuvant immune-cell therapy had a greater risk of adverse events in DC vaccine therapy. Injection-site reactions were the most frequently reported adverse events, with 449 events, the majority of which were associated with DC vaccine therapy. Among all other adverse events, fever (228 events), fatigue (141 events) and itching (131 events) were frequently reported. In contrast, three patients had adverse events (fever, abdominal pain and interstitial pneumonia) that required hospitalization, although they were weakly related to this therapy; rather, it was considered to be the effect of treatment for the primary disease.
    Immune-cell therapy for cancer was considered to be a safe treatment without serious adverse events.
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  • 文章类型: Journal Article
    背景:SCLC是一种高度侵袭性的肿瘤,5年生存率低于6%。一种异质性疾病,SCLC分为四种亚型,包括具有神经内分泌和非神经内分泌特征的肿瘤。最近为SCLC的前线治疗添加了免疫检查点阻断;然而,这种疗法仅导致适度的临床改善.已知具有高肿瘤突变负担的癌症类型中缺乏临床益处已归因于大多数SCLC肿瘤中较差的T细胞浸润和I类MHC的低表达。为了设计更有效的免疫治疗方案,这项研究调查了另一种方法的基础上使用的临床阶段白介素-15超激动剂,N-803。
    方法:使用跨所有分子亚型的SCLC的临床前模型来评估SCLC对自然杀伤(NK)介导的体外裂解的敏感性,包括由N-803激活的NK细胞。用SCLC的异种移植模型在体内评估N-803的抗肿瘤活性。
    结果:体外和体内数据显示,SCLC亚型对NK细胞裂解的敏感性存在差异,N-803激活的NK细胞可有效裂解所有变异亚型的SCLC肿瘤细胞,无论MHC-I类的表达如何。
    结论:这些发现强调了使用基于细胞因子的治疗方案的新型免疫干预治疗SCLC的潜力。我们假设N-803可能对大多数SCLC患者有益,包括那些缺乏MHC表达的免疫冷肿瘤。
    BACKGROUND: SCLC is a highly aggressive tumor with a 5-year survival rate of less than 6%. A heterogeneous disease, SCLC is classified into four subtypes that include tumors with neuroendocrine and non-neuroendocrine features. Immune checkpoint blockade has been recently added for the frontline treatment of SCLC; however, this therapy has only led to modest clinical improvements. The lack of clinical benefit in a cancer type known to have a high tumor mutational burden has been attributed to poor T-cell infiltration and low expression of MHC-class I in most SCLC tumors. In an attempt to devise a more effective immunotherapeutic regimen, this study investigated an alternate approach on the basis of the use of the clinical-stage interleukin-15 superagonist, N-803.
    METHODS: Preclinical models of SCLC spanning all molecular subtypes were used to evaluate the susceptibility of SCLC to natural killer (NK)-mediated lysis in vitro, including NK cells activated by N-803. Antitumor activity of N-803 was evaluated in vivo with a xenograft model of SCLC.
    RESULTS: In vitro and in vivo data revealed differences in susceptibility of SCLC subtypes to lysis by NK cells and that NK cells activated by N-803 effectively lyse SCLC tumor cells across all variant subtypes, regardless of their expression of MHC-class I.
    CONCLUSIONS: These findings highlight the potential of a novel immune-based intervention using a cytokine-based therapeutic option for the treatment of SCLC. We hypothesize that N-803 may provide benefit to most patients with SCLC, including those with immunologically cold tumors lacking MHC expression.
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  • 文章类型: Journal Article
    The susceptibility of cancer cells to natural killer (NK) cell-mediated cytotoxicity depends on the balance of activating and inhibitory ligands expressed on their surface. Although many types of cancer cells are killed by NK cells, non-small-cell lung cancer (NSCLC) cells are relatively resistant to NK cell-mediated cytotoxicity. In this study, we showed that several NSCLC cell lines have differential sensitivity to NK cell-mediated cytotoxicity: NCI-H522 cells were highly sensitive, but A549, NCI-H23, NCI-H1915, and NCI-H1299 were resistant. Among activating ligands such as CD48, HLA-A/B/G, ICAM-1, MICA/B, and ULBPs, only CD48 rendered NCI-H522 cells susceptible to NK cell-mediated cytotoxicity, which was proved by using CD48 siRNA and neutralizing antibody. CD48-positive NCI-H522 cells established a more stable contact with NK cells than did CD48-negative A549 and CD48 siRNA cell-transfected NCI-H522 cells. Taken together, these data demonstrate that CD48-positive NSCLC cells might be susceptible to NK cell-mediated cytotoxicity, which provide information on how to stratify NSCLC patients potentially responsive to NK-cell therapy.
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  • 文章类型: Journal Article
    Immunotherapy in cancer takes advantage of the exquisite specificity, potency, and flexibility of the immune system to eliminate alien tumor cells. It involves strategies to activate the entire immune defense, by unlocking mechanisms developed by tumor cells to escape from surrounding immune cells, as well as engineered antibody and cellular therapies. What is important to note is that these are therapeutics with curative potential. The earliest example of immune therapy is allogeneic stem cell transplantation, introduced in 1957, which is still an important modality in hematology, most notably in myeloid malignancies. In this review, we discuss developmental trends of immunotherapy in hematological malignancies, focusing on some of the strategies that we believe will have the most impact on future clinical practice in this field. In particular, we delineate novel developments for therapies that have already been introduced into the clinic, such as immune checkpoint inhibition and chimeric antigen receptor T-cell therapies. Finally, we discuss the therapeutic potential of emerging strategies based on T-cell receptors and adoptive transfer of allogeneic natural killer cells.
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