Dipartimento di Ematologia ed Oncologia Pediatrica, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Curr Opin Infect Dis. 2012 Aug;25(4):431-7. doi: 10.1097/QCO.0b013e3283551dd3.
The continuous and successful expansion of organ transplants is unfortunately associated with increased incidence of severe opportunistic viral infections and Epstein-Barr virus (EBV)-related lymphomas secondary to immunosuppression. Here, we review the strengths and limitations of T-cell-based strategies used to treat viral infections in immunocompromised individuals.
While current antiviral drugs are often suboptimal because of associated toxicities, a promising approach in the management of infections with viruses like cytomegalovirus (CMV), adenovirus (AdV) and EBV is the adoptive transfer of T cells targeting these viruses that can be directly isolated from the peripheral blood of the donor or expanded ex vivo prior to infusions in patients.
T-cell-based immunotherapies are now being included in the clinical practice of transplant recipients to prevent and treat infections and complications associated with CMV, AdV and EBV. Improvement of current limitations will enable the extension of these approaches to all patients at risk and to other clinically relevant viruses and pathogens that are emerging as significant complications for immunocompromised patients.
器官移植的持续成功扩展,不幸的是与免疫抑制相关的严重机会性病毒感染和 EBV 相关淋巴瘤的发生率增加有关。在这里,我们回顾了用于治疗免疫功能低下个体病毒感染的基于 T 细胞的策略的优缺点。
由于相关毒性,目前的抗病毒药物往往效果不佳,对于治疗巨细胞病毒 (CMV)、腺病毒 (AdV) 和 EBV 等病毒的感染,一种有前途的方法是采用针对这些病毒的 T 细胞过继转移,这些 T 细胞可以直接从供体的外周血中分离出来,也可以在输注给患者之前在体外进行扩增。
基于 T 细胞的免疫疗法现在已被纳入移植受者的临床实践中,以预防和治疗与 CMV、AdV 和 EBV 相关的感染和并发症。改善当前的局限性将使这些方法能够扩展到所有有风险的患者以及其他临床上相关的病毒和病原体,这些病毒和病原体已成为免疫功能低下患者的严重并发症。