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CAR-NK是否优于CAR-T细胞免疫疗法? [复制链接]

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楼主
发表于 2015-11-11 10:59 |只看该作者 |倒序浏览 |打印
作者:疑夕
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On December 15, 2014, Patrick Soon Shiong, the richest physician in the world, acquired 19.9% of Sorrento Therapeutics (NASDAQ: SRNE)’s equity at $5.80 per share (about 41.7 million). Four days later, Sorrento and Conkwest announced an agreement to co-develop CAR-NK immunotherapy. Sorrento’s stock price reached a high of $11.38 on January 15, 2015.
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CAR-T cell immunotherapy has been regarded as one of the most compelling breakthroughs in cancer treatment in recent years. Companies working on CAR-T (e.g., JUNO, KITE, BLCM, BLUE, ZIOP) are red hot at present. Sorrento/Conkwest is developing CAR-expressing NK cells rather than T cells to kill cancer cells. How about CAR-TNK compares to CAR-T?2 G( G1 D! R! P( I8 j

& V6 D; ]9 q0 e% PHere is a comparison published in OncoImmunology[1]. The author, Hans Klingemann, is the inventor of the NK-92 cell line and co-founded ZelleRx in 2002, which was renamed Conkwest in 2010. CAR-NK has many several advantages over CAR-T:
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: q" c) Q% c9 Z4 c7 f. i$ r- b3 x9 ^(1) CAR-NK cells don’t produce IL-6 which is associated with the cytokine release syndrome. A series of patient deaths in the trials of CAR-T were linked to unusually high levels of IL-6.
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(2) CAR-NK cells disappear relatively rapidly from the circulation owing to their limited lifespan. There is no concern about persisting CAR-associated side effects. Whereas Juno Therapeutics has to insert EGFRt gene into the CAR-T cells to control them.
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. L6 k1 K3 l/ W* E3 R- k! r(3) NK cells are known as serial killers which diligently moves from one target to the next one, killing on as many as 7-10 cells.
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7 v; p4 Q/ P2 x$ S" i1 }' M% O" O2 n(4) The transfection efficiency of NK-92 cells is about 50%, even with non-viral methods. Avoiding viral vectors eliminates the risks of oncogene activation and insertional mutagenesis.
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6 \0 r" F2 H  i; f(5) CAR-NK cells can also be produced in large scaleunder GMP conditions. Moerover, it may be used in the setting of allogeneic transplantation.( z( i* @; x. R

( ?+ H* h  a: @  W9 wNaturally, only about 10% of circulating lymphocytes are NK cells. The activation of NK cells is determined by the balance of inhibitory and activating receptor stimulation. MHC class I molecules in normal cells inhibit the activation of NK cells./ o: F7 k) F) o3 |  o! m2 N. V' G7 I

! n9 N0 I8 L- }8 tNatural NK cells do not express antigen specific receptors. Can CAR-NK cells equipped with an antigen specific receptor kill cancer cells as effectively as CAR-T cells? Hard to say.; c" R. n' m8 x3 w2 J9 `. I
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Preclinical studies in leukemia, lymphoma, and multiple myeloma have been reported. For instance, treatment with anti-CS1 CAR-NK cells prolonged the survival of multiple myeloma mice from 40 days to 50 days[2].
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: V; b: q1 C" U; x  z: lSorrento intends to develop anti-CD19, anti-PDL1, anti-PSMA, and anti-CD123 CAR-NK cells. It is expected to initiate Phase I trials in 2016.: w# s) J! X- z7 Q8 F7 s
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[1] Oncoimmunology. 2014, 3, e28147. doi: 10.4161/onci.28147.: G! C) \- A; O0 {  n# _; |
[2] Leukemia. 2014, 28(4), 917-927.
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Related Articles:6 |0 k7 P& T+ n& ^1 ~4 o6 y
What are the next generation T cell immunotherapies
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沙发
发表于 2015-11-12 09:32 |只看该作者
回复 cantonchn 的帖子8 y! M; P* `0 R8 Q) {5 C
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有中文的么?  英文的看起来有点难啊  

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藤椅
发表于 2015-11-12 21:10 |只看该作者
本帖最后由 cneagle66 于 2015-11-12 21:15 编辑   w' E1 A5 l/ n

& S+ p" ~% y$ [* \& w# [2014年12月15日,Patrick Soon Shiong,世界上最富的医生,获得了Sorrento Therapeutic公司19.9%的股票,每股价格5.80美元,4天后,Sorrento and Conkwest 宣布共同开发CAR-NK免疫疗法,Sorrento的股票价格在2015年1月15上涨到每股11.38美元。7 N, r9 N, R* Y
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CAR-T细胞免疫疗法被认为是近年来肿瘤治疗的突破性进展,很多开发CAR-T的公司(如JUNO, KITE, BLCM, BLUE, ZIOP)现在热的发红,Sorrento/Conkwest 正在研发表达CAR的NK细胞,而不是T细胞,CAR-NK和CAR-T相比如何?
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3 i( G3 `9 f# C8 O  P在OncoImmunology上有这样的比较,Hans Klingeman是NK-92细胞系的发明者,和他人在2002年共建了ZelleRx,即2010年更名为Conkwest的公司。CAR-NK具有很多优势:6 \( V6 ?& v8 D; b3 q5 R* W' D

* V- H& J1 Z7 Q5 ?7 f) f" a(1)CAR-NK不产生IL-6,后者是细胞因子释放综合征的元凶,CAR-T治疗的临床试验所造成的多起患者死亡,都和IL-6升高有关。
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(2) CAR-NK 由于寿命较短,在外周循环中消除较快,不必担心持久的CAR相关的副反应。相应地 JUNO Therapeutics已经着手,插入EGFRt基因以控制CAR-T细胞的效应。
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9 e6 ^& i. x! v+ e3 ?. q% f9 t(3)NK细胞是连环杀手,可以聪明地从一个目标移动到另一目标,杀灭7-10个细胞。
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3 C% w& n! _9 {5 o4 h2 \, J3 Y(4)NK-92细胞的转染效率达50%,甚至是非病毒载体也可轻易转染。不用病毒载体,就避免了癌基因的激活,插入突变等风险。
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2 h4 J! e7 _& c: x(5)CAR-NK也可在GMP状态下批量生产,并可用于异体。) g. x- C' _; k2 h* P1 X& T$ y  v& {

' Y3 v$ U8 z) H9 l; K通常,血循环中只有10%的NK,NK的活化依赖于抑制和活化受体刺激信号之间的平衡,正常细胞中的MHC I类分子抑制NK的活化。0 c- P7 R8 d/ K+ {7 @* q' z
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天然的NK细胞不表达抗原特异性受体,装备了抗原特异性受体的CAR-NK是不是也和CAR-T一样有效的杀伤癌细胞,还很难说。+ T: b/ ?# [1 r* e1 y7 }

8 u$ A* w0 ~: Y8 `& y! s! q已经有了临床前的白血病、淋巴瘤、多发性骨髓瘤的报道,如用抗-CS1的CAR-NK治疗,可以延缓多发性骨髓瘤小鼠生存期,从40天延长到50天。7 I$ ^  @0 x  d7 e/ B+ H

  U, ^: W! W  a9 ]Sorrento公司计划开发抗CD19、PD-L1、PMSA、CD123的CAR-NK,预计2016年开始临床I期试验。
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板凳
发表于 2015-11-19 18:27 |只看该作者
干细胞之家微信公众号
学习啦

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报纸
发表于 2015-11-20 13:46 |只看该作者
回复 cneagle66 的帖子
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  c; c& \: J" m2 m. I7 a  m外周血中的NK数量应该没有10%这么多,正常在4%~6%之间。
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地板
发表于 2020-2-3 12:49 |只看该作者
回复 cantonchn 的帖子
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5 }; E8 w7 j+ L0 h, s# t也是需要纯化的
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