Cooke Rachel E, Koldej Rachel, Ritchie David
Australian Cancer Research Foundation (ACRF) Translational Laboratory, Royal Melbourne Hospital, Melbourne, Australia.
Department of Medicine, University of Melbourne, Melbourne, Australia.
J Oncol. 2019 Apr 10;2019:2186494. doi: 10.1155/2019/2186494. eCollection 2019.
Multiple myeloma (MM) is usually diagnosed in older adults at the time of immunosenescence, a collection of age-related changes in the immune system that contribute to increased susceptibility to infection and cancer. The MM tumor microenvironment and cumulative chemotherapies also add to defects in immunity over the course of disease. In this review we discuss how mouse models have furthered our understanding of the immune defects caused by MM and enabled immunotherapeutics to progress to clinical trials, but also question the validity of using immunodeficient models for these purposes. Immunocompetent models, in particular the 5T series and VkMYC models, are increasingly being utilized in preclinical studies and are adding to our knowledge of not only the adaptive immune system but also how the innate system might be enhanced in anti-MM activity. Finally we discuss the concept of immune profiling to target patients who might benefit the most from immunotherapeutics, and the use of humanized mice and 3D culture systems for personalized medicine.
多发性骨髓瘤(MM)通常在免疫衰老期被诊断出来,免疫衰老指的是免疫系统中一系列与年龄相关的变化,这些变化会导致个体对感染和癌症的易感性增加。MM肿瘤微环境和累积化疗也会在疾病过程中加剧免疫缺陷。在这篇综述中,我们讨论了小鼠模型如何加深了我们对MM所致免疫缺陷的理解,并使免疫疗法得以推进到临床试验阶段,但同时也质疑了使用免疫缺陷模型用于这些目的的有效性。具有免疫活性的模型,特别是5T系列和VkMYC模型,越来越多地被用于临床前研究,不仅增加了我们对适应性免疫系统的了解,还让我们了解了先天免疫系统在抗MM活性中如何得到增强。最后,我们讨论了免疫谱分析的概念,以确定哪些患者可能从免疫疗法中获益最多,以及使用人源化小鼠和3D培养系统进行个性化医疗。