Foley R, Tozer R, Wan Y
Department of Laboratory Medicine, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada.
Transfus Med Rev. 2001 Oct;15(4):292-304. doi: 10.1053/tmrv.2001.26960.
Dendritic cells (DCs) are a heterogeneous population of antigen-presenting cells (APCs) identified in various tissues, including the skin (Langerhans cells), lymph nodes (interdigitating and follicular DCs), spleen, and thymus. Properties of DCs include the ability to (1) capture, process, and present foreign antigens; (2) migrate to lymphoid-rich tissue; and (3) stimulate innate and adaptive antigen-specific immune responses. Until recently, the ability to study DCs has been limited by their absence in most culture systems. It is now known that specific cytokines can be used to expand DCs to numbers sufficient for their in vitro evaluation and for their use in human immunotherapy trials. Human DCs can be derived from hematopoietic progenitors (CD34+-derived DCs) or from adherent peripheral blood monocytes (monocyte-derived DCs). Cultured DCs can be recognized by a typical veiled morphologic appearance and expression of surface markers that include major histocompatibility complex class II, CD86/B7.2, CD80/B7.1, CD83, and CD1a. DCs are susceptible to a variety of gene transfer protocols, which can be used to enhance biological function in vivo. Transduction of DCs with genes for defined tumor antigens results in sustained protein expression and presentation of multiple tumor peptides to host T cells. Alternatively, DCs may be transduced with genes for chemokines or immunostimulatory cytokines. Although the combination of ex vivo DC expansion and gene transfer is relatively new, preliminary studies suggest that injection of genetically modified autologous DCs may be capable of generating anti-tumor immune responses in patients with cancer. Preclinical animal studies showing potent antigen-specific tumor immunity after DC-based vaccination support this hypothesis and provide rationale to further evaluate this approach in patients. Preliminary human studies are now required to evaluate optimal DC dose, schedule of vaccination, route of delivery, and maturational state of cultured cells. Initiation of these phase I/II cell therapy-based studies will occur in collaboration with hospital-based transfusion facilities. Issues relating to cell harvesting, storage, culture methodology, and administration require the collaborative efforts of basic scientists, immunologists, clinical investigators, and transfusion medicine staff to ensure strict quality control of injected cellular products. This review is intended to provide a brief overview of clinical DC-based gene transfer.
树突状细胞(DCs)是一类异质性的抗原呈递细胞(APC),存在于包括皮肤(朗格汉斯细胞)、淋巴结(交错突细胞和滤泡性DCs)、脾脏和胸腺在内的多种组织中。DCs的特性包括:(1)捕获、处理和呈递外来抗原的能力;(2)迁移至富含淋巴细胞组织的能力;(3)刺激先天性和适应性抗原特异性免疫反应的能力。直到最近,由于在大多数培养系统中缺乏DCs,对其进行研究的能力一直受到限制。现在已知特定的细胞因子可用于将DCs扩增至足以进行体外评估及用于人类免疫治疗试验的数量。人类DCs可源自造血祖细胞(CD34⁺来源的DCs)或贴壁的外周血单核细胞(单核细胞来源的DCs)。培养的DCs可通过典型的面纱样形态外观以及包括主要组织相容性复合体II类、CD86/B7.2、CD80/B7.1、CD83和CD1a在内的表面标志物的表达来识别。DCs易受多种基因转移方案的影响,这些方案可用于增强其体内生物学功能。用特定肿瘤抗原的基因转导DCs会导致持续的蛋白质表达,并将多种肿瘤肽呈递给宿主T细胞。或者,DCs可用趋化因子或免疫刺激细胞因子的基因进行转导。尽管体外DC扩增和基因转移的联合应用相对较新,但初步研究表明,注射经基因改造的自体DCs可能能够在癌症患者中产生抗肿瘤免疫反应。临床前动物研究显示基于DC的疫苗接种后具有强大的抗原特异性肿瘤免疫,支持了这一假设,并为在患者中进一步评估这种方法提供了理论依据。现在需要进行初步的人体研究,以评估最佳的DC剂量、疫苗接种方案、给药途径以及培养细胞的成熟状态。这些基于I/II期细胞治疗的研究将与医院输血设施合作开展。与细胞采集、储存、培养方法和给药相关的问题需要基础科学家、免疫学家、临床研究人员和输血医学人员的共同努力,以确保注射的细胞产品的严格质量控制。本综述旨在简要概述基于临床DC的基因转移。