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我们能否通过细胞疗法预防或治疗移植物抗宿主病?

Can we prevent or treat graft-versus-host disease with cellular-therapy?

机构信息

Department of Internal Medicine, Temple University Hospital, Philadelphia, PA, USA.

Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Blood Rev. 2020 Sep;43:100669. doi: 10.1016/j.blre.2020.100669. Epub 2020 Feb 4.

Abstract

Acute and chronic graft-versus-host disease (GvHD) are the most important causes of treatment-related morbidity and mortality after allogeneic hematopoietic cell transplants for various diseases. Corticosteroids are an effective therapy in only about one-half of affected individuals and new therapy options are needed. We discuss novel strategies to treat GvHD using cellular-therapy including adoptive transfer of regulatory T-cells (T), mesenchymal stromal cells (MSCs), cells derived from placental tissues, invariant natural killer T-cells (iNKTs), and myeloid-derived suppressor cells (MDSCs).These strategies may be more selective than drugs in modulating GvHD pathophysiology, and may be safer and more effective than conventional pharmacologic therapies. Additionally, these therapies have not been observed to substantially compromise the graft-versus-tumor effect associated with allotransplants. Many of these strategies are effective in animal models but substantial data in humans are lacking.

摘要

急性和慢性移植物抗宿主病(GvHD)是各种疾病异基因造血细胞移植后治疗相关发病率和死亡率的最重要原因。皮质类固醇在大约一半的受影响个体中是有效的治疗方法,需要新的治疗选择。我们讨论了使用细胞治疗治疗 GvHD 的新策略,包括过继转移调节性 T 细胞(T 细胞)、间充质基质细胞(MSCs)、胎盘组织来源的细胞、不变自然杀伤 T 细胞(iNKT 细胞)和髓源抑制细胞(MDSCs)。与药物相比,这些策略在调节 GvHD 病理生理学方面可能更具选择性,并且可能比传统的药物治疗更安全、更有效。此外,这些治疗方法并未观察到与同种异体移植相关的抗肿瘤效应有实质性损害。这些策略中的许多在动物模型中是有效的,但在人类中缺乏大量数据。

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