Dietz A B, Padley D J, Gastineau D A
Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Clin Pharmacol Ther. 2007 Sep;82(3):320-4. doi: 10.1038/sj.clpt.6100288. Epub 2007 Jul 18.
The common conception of a drug is that of a chemical with defined medicinal effect. However, cells used as drugs remain critical to patient care. Cell therapy's origins began with the realization that complex tissues such as blood can retain function when transplanted to the patient. More complex transplantation followed, culminating with the understanding that transplantation of some tissues such as bone marrow may act medicinally. Administration of cells with an intended therapeutic effect is a hallmark of cellular therapy. While cells have been used as drugs for decades, testing a specific therapeutic effect of cells has begun clinical testing relatively recently. Lessons learned during the establishment of blood banking (including the importance of quality control, process control, sterility, and product tracking) are key components in the assurance of the safety and potency of cell therapy preparations. As more academic medical centers and private companies move toward exploiting the full potential of cells as drugs, needs arise for the development of the infrastructure necessary to support these investigations. Careful consideration of the design of the structure used to manufacture is important in terms of the significant capital outlay involved and the facility's role in achieving regulatory compliance. This development perspective describes the regulatory environment surrounding the infrastructure support for cell therapy and practical aspects for design consideration with particular focus on those activities associated with early clinical trials.
药物的普遍概念是一种具有明确药用效果的化学物质。然而,用作药物的细胞对患者护理仍然至关重要。细胞疗法起源于人们认识到诸如血液等复杂组织在移植到患者体内时仍能保持功能。随后进行了更复杂的移植,最终人们认识到某些组织如骨髓的移植可能具有药用作用。给予具有预期治疗效果的细胞是细胞疗法的一个标志。虽然细胞作为药物已经使用了几十年,但对细胞特定治疗效果的测试直到最近才开始临床试验。在建立血库过程中吸取的经验教训(包括质量控制、过程控制、无菌和产品追踪的重要性)是确保细胞疗法制剂安全性和效力的关键要素。随着越来越多的学术医疗中心和私人公司致力于充分发挥细胞作为药物的潜力,开发支持这些研究所需的基础设施的需求也随之出现。鉴于涉及的大量资本支出以及该设施在实现法规合规方面的作用,仔细考虑用于制造的结构设计非常重要。这一发展视角描述了围绕细胞疗法基础设施支持的监管环境以及设计考虑的实际方面,特别关注与早期临床试验相关的那些活动。