Wheeler Christopher J, Black Keith L
MDNSI, Cedars-Sinai Medical Center, 8631 W. Third Street, Suite 800E, Los Angeles, CA 90048, USA.
Front Biosci. 2005 Sep 1;10:2861-81. doi: 10.2741/1743.
The dismal prognoses suffered by malignant primary brain tumor (glioma) patients remain unchanged over the past two decades despite significant improvements in the treatment of distinct tumors. Immunotherapy, and vaccine therapy in particular, represents a promising experimental approach to treat malignant gliomas, but major challenges still remain to render vaccination clinically effective. These challenges include diminishing the risk of pathologic autoimmunity, and identifying the cellular basis of clinical vaccine benefits. Addressing such challenges should eventually help increase the proportion of patients experiencing clinical vaccine benefits. Recent studies in glioma patients have characterized tumor antigens on human gliomas, identified some of the immune cells involved in beneficial anti-glioma immunity, and examined how gliomas may be altered by sub-lethal immune influences. This has provided a glimpse of the strength to which immunity influences glioma clinical outcome, and resurrects hope that clinically effective vaccines to treat these tumors is within reach. Insight into the complex dynamics of immune-tumor interactions promises to extend this reach by delineating mechanisms of immune synergy with other forms of treatment.
尽管在不同肿瘤的治疗方面取得了显著进展，但恶性原发性脑肿瘤（胶质瘤）患者的预后在过去二十年中仍未改变。免疫疗法，尤其是疫苗疗法，是一种有前景的治疗恶性胶质瘤的实验方法，但要使疫苗在临床上有效仍面临重大挑战。这些挑战包括降低病理性自身免疫的风险，以及确定临床疫苗获益的细胞基础。应对这些挑战最终应有助于增加从临床疫苗中获益的患者比例。最近对胶质瘤患者的研究已经对人类胶质瘤上的肿瘤抗原进行了表征，确定了一些参与有益抗胶质瘤免疫的免疫细胞，并研究了胶质瘤如何受到亚致死性免疫影响的改变。这让我们初步了解了免疫对胶质瘤临床结果的影响程度，并重新燃起了希望，即治疗这些肿瘤的临床有效疫苗即将问世。深入了解免疫 - 肿瘤相互作用的复杂动态，有望通过阐明与其他治疗形式的免疫协同机制来扩大这一前景。
