癌症的免疫精准医学:基于免疫效应细胞效率的新见解。

Immune precision medicine for cancer: a novel insight based on the efficiency of immune effector cells.

机构信息

Institut Sainte Catherine, 84918, Avignon, France.

Université Montpellier 1, UFR Médecine, 34396, Montpellier, France.

出版信息

Cancer Commun (Lond). 2019 Jun 14;39(1):34. doi: 10.1186/s40880-019-0379-3.

Abstract

Cancer cell growth is associated with immune surveillance failure. Nowadays, restoring the desired immune response against cancer cells remains a major therapeutic strategy. Due to the recent advances in biological knowledge, efficient therapeutic tools have been developed to support the best bio-clinical approaches for immune precision therapy. One of the most important successes in immune therapy is represented by the applicational use of monoclonal antibodies, particularly the use of rituximab for B-cell lymphoproliferative disorders. More recently, other monoclonal antibodies have been developed, to inhibit immune checkpoints within the tumor microenvironment that limit immune suppression, or to enhance some immune functions with immune adjuvants through different targets such as Toll-receptor agonists. The aim is to inhibit cancer proliferation by the diminishing/elimination of cancer residual cells and clinically improving the response duration with no or few adverse effects. This effect is supported by enhancing the number, functions, and activity of the immune effector cells, including the natural killer (NK) lymphocytes, NKT-lymphocytes, γδ T-lymphocytes, cytotoxic T-lymphocytes, directly or indirectly through vaccines particularly with neoantigens, and by lowering the functions of the immune suppressive cells. Beyond these new therapeutics and their personalized usage, new considerations have to be taken into account, such as epigenetic regulation particularly from microbiota, evaluation of transversal functions, particularly cellular metabolism, and consideration to the clinical consequences at the body level. The aim of this review is to discuss some practical aspects of immune therapy, giving to clinicians the concept of immune effector cells balancing between control and tolerance. Immunological precision medicine is a combination of modern biological knowledge and clinical therapeutic decisions in a global vision of the patient.

摘要

癌细胞的生长与免疫监视失败有关。如今,恢复对癌细胞的理想免疫反应仍然是主要的治疗策略。由于最近生物学知识的进步,已经开发出有效的治疗工具来支持免疫精准治疗的最佳生物临床方法。免疫治疗的最重要成功之一是单克隆抗体的应用,特别是利妥昔单抗在 B 细胞淋巴增生性疾病中的应用。最近,已经开发出其他的单克隆抗体,以抑制肿瘤微环境中的免疫检查点,从而限制免疫抑制,或者通过不同的靶点(如 Toll 受体激动剂)用免疫佐剂增强某些免疫功能。其目的是通过减少/消除癌症残留细胞来抑制癌症增殖,并在没有或很少有不良反应的情况下临床改善反应持续时间。这种效应通过增强免疫效应细胞(包括自然杀伤 (NK) 淋巴细胞、NKT 淋巴细胞、γδ T 淋巴细胞、细胞毒性 T 淋巴细胞)的数量、功能和活性来支持,包括通过疫苗,特别是新抗原,直接或间接增强,以及降低免疫抑制细胞的功能。除了这些新的治疗方法及其个性化应用之外,还必须考虑新的因素,例如特别是来自微生物群的表观遗传调控、横向功能(特别是细胞代谢)的评估,以及在身体水平上考虑临床后果。本文的目的是讨论免疫治疗的一些实际方面,向临床医生介绍免疫效应细胞在控制和耐受之间平衡的概念。免疫精准医学是现代生物学知识与临床治疗决策的结合,是从整体角度看待患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b483/6567551/7647bda77020/40880_2019_379_Fig1_HTML.jpg

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