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18F-FDG PET/CT metrics-based stratification of large B-cell lymphoma receiving CAR-T cell therapy: immunosuppressive tumor microenvironment as a negative prognostic indicator in patients with high tumor burden 基于18F-FDG PET/CT指标对接受CAR-T细胞疗法的大B细胞淋巴瘤进行分层:免疫抑制性肿瘤微环境是高肿瘤负荷患者的一个负面预后指标
IF 11.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-14 DOI: 10.1186/s40364-024-00650-5
Ling-Shuang Sheng, Rong Shen, Zi-Xun Yan, Chao Wang, Xin Zheng, Yi-Lun Zhang, Hao-Xu Yang, Wen Wu, Peng-Peng Xu, Shu Cheng, Emmanuel Bachy, Pierre Sesques, Nicolas Jacquet-Francillon, Xu-Feng Jiang, Wei-Li Zhao, Li Wang
Chimeric antigen receptor T (CAR-T) cell therapy has greatly improved the prognosis of relapsed and refractory patients with large B-cell lymphoma (LBCL). Early identification and intervention of patients who may respond poorly to CAR-T cell therapy will help to improve the efficacy. Ninety patients from a Chinese cohort who received CAR-T cell therapy and underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans at the screening stage (median time to infusion 53.5 days, range 27–176 days), 1 month and 3 months after CAR-T cell infusion were analyzed, with RNA-sequencing conducted on 47 patients at the screening stage. Patients with maximum diameter of the largest lesion (Dmax) < 6 cm (N = 60) at screening stage showed significantly higher 3-month complete response rate (85.0% vs. 33.3%, P < 0.001), progression-free survival (HR 0.17; 95% CI 0.08–0.35, P < 0.001) and overall survival (HR 0.18; 95% CI 0.08–0.40, P < 0.001) than those with Dmax ≥ 6 cm (N = 30). Besides, at the screening stage, Dmax combined with extranodal involvement was more efficient in distinguishing patient outcomes. The best cut-off values for total metabolic tumor volume (tMTV) and total lesion glycolysis (tTLG) at the screening stage were 50cm3 and 500 g, respectively. A prediction model combining maximum standardized uptake value (SUVmax) at 1 month after CAR-T cell therapy (M1) and tTLG clearance rate was established to predict early progression for partial response/stable disease patients evaluated at M1 after CAR-T cell therapy and validated in Lyon cohort. Relevant association of the distance separating the two farthest lesions, standardized by body surface area to the severity of neurotoxicity (AUC = 0.74; P = 0.034; 95% CI, 0.578–0.899) after CAR-T cell therapy was found in patients received axicabtagene ciloleucel. In patients with Dmax ≥ 6 cm, RNA-sequencing analysis conducted at the screening stage showed enrichment of immunosuppressive-related biological processes, as well as increased M2 macrophages, cancer-associated fibroblasts, myeloid-derived suppressor cells, and intermediate exhausted T cells. Collectively, immunosuppressive tumor microenvironment may serve as a negative prognostic indicator in patients with high tumor burden who respond poorly to CAR-T cell therapy.
嵌合抗原受体T(CAR-T)细胞疗法大大改善了大B细胞淋巴瘤(LBCL)复发和难治患者的预后。早期识别和干预可能对CAR-T细胞疗法反应不佳的患者将有助于提高疗效。研究人员分析了中国队列中接受CAR-T细胞治疗的90例患者,这些患者在筛查阶段(输注CAR-T细胞的中位时间为53.5天,范围为27-176天)、输注CAR-T细胞后1个月和3个月接受了18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT),47例患者在筛查阶段接受了RNA测序。在筛查阶段,最大病灶直径(Dmax)<6厘米的患者(N = 60)的3个月完全应答率(85.0% vs. 33.3%,P<0.001)、无进展生存期(HR 0.17;95% CI 0.08-0.35,P<0.001)和总生存期(HR 0.18;95% CI 0.08-0.40,P<0.001)均显著高于Dmax≥6厘米的患者(N = 30)。此外,在筛查阶段,Dmax结合结节外受累在区分患者预后方面更有效。在筛查阶段,肿瘤总代谢体积(tMTV)和病变总糖酵解量(tTLG)的最佳临界值分别为 50 立方厘米和 500 克。结合CAR-T细胞治疗后1个月(M1)的最大标准化摄取值(SUVmax)和tTLG清除率,建立了一个预测模型,用于预测CAR-T细胞治疗后M1时评估的部分反应/疾病稳定患者的早期进展,并在里昂队列中进行了验证。在接受 axicabtagene ciloleucel 治疗的患者中,发现 CAR-T 细胞治疗后两个最远病灶之间的距离(按体表面积标准化)与神经毒性的严重程度有相关性(AUC = 0.74;P = 0.034;95% CI,0.578-0.899)。在Dmax≥6厘米的患者中,筛选阶段进行的RNA测序分析显示,免疫抑制相关的生物过程以及M2巨噬细胞、癌症相关成纤维细胞、髓源抑制细胞和中间衰竭T细胞增多。总而言之,免疫抑制性肿瘤微环境可作为对 CAR-T 细胞疗法反应不佳的高肿瘤负荷患者的一个负面预后指标。
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引用次数: 0
Single-cell, single-nucleus and xenium-based spatial transcriptomics analyses reveal inflammatory activation and altered cell interactions in the hippocampus in mice with temporal lobe epilepsy 基于单细胞、单核和氙的空间转录组学分析揭示了颞叶癫痫小鼠海马中的炎症激活和细胞相互作用的改变
IF 11.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-13 DOI: 10.1186/s40364-024-00636-3
Quanlei Liu, Chunhao Shen, Yang Dai, Ting Tang, Changkai Hou, Hongyi Yang, Yihe Wang, Jinkun Xu, Yongchang Lu, Yunming Wang, Yongzhi Shan, Penghu Wei, Guoguang Zhao
Temporal lobe epilepsy (TLE) is among the most common types of epilepsy and often leads to cognitive, emotional, and psychiatric issues due to the frequent seizures. A notable pathological change related to TLE is hippocampal sclerosis (HS), which is characterized by neuronal loss, gliosis, and an increased neuron fibre density. The mechanisms underlying TLE-HS development remain unclear, but the reactive transcriptomic changes in glial cells and neurons of the hippocampus post-epileptogenesis may provide insights. To induce TLE, 200 nl of kainic acid (KA) was stereotactically injected into the hippocampal CA1 region of mice, followed by a 7-day postinjection period. Single-cell RNA sequencing (ScRNA-seq), single-nucleus RNA sequencing (SnRNA-seq), and Xenium-based spatial transcriptomics analyses were employed to evaluate the changes in mRNA expression in glial cells and neurons. From the ScRNA-seq and SnRNA-seq data, 31,390 glial cells and 48,221 neuronal nuclei were identified. Analysis of the differentially expressed genes (DEGs) revealed significant transcriptomic alterations in the hippocampal cells of mice with TLE, affecting hundreds to thousands of mRNAs and their signalling pathways. Enrichment analysis indicated notable activation of stress and inflammatory pathways in the TLE hippocampus, while pathways related to axonal development and neural support were suppressed. Xenium analysis demonstrated the expression of all 247 genes across mouse brain sections, revealing the spatial distributions of their expression in 27 cell types. Integrated analysis of the DEGs identified via the three sequencing techniques revealed that Spp1, Trem2, and Cd68 were upregulated in all glial cell types and in the Xenium data; Penk, Sorcs3, and Plekha2 were upregulated in all neuronal cell types and in the Xenium data; and Tle4 and Sipa1l3 were downregulated in all glial cell types and in the Xenium data. In this study, a high-resolution single-cell transcriptomic atlas of the hippocampus in mice with TLE was established, revealing potential intrinsic mechanisms driving TLE-associated inflammatory activation and altered cell interactions. These findings provide valuable insights for further exploration of HS development and epileptogenesis.
颞叶癫痫(TLE)是最常见的癫痫类型之一,由于频繁发作,常常导致认知、情感和精神方面的问题。与颞叶癫痫相关的一个显著病理变化是海马硬化(HS),其特征是神经元缺失、胶质细胞增生和神经元纤维密度增加。TLE-HS的发病机制尚不清楚,但癫痫发生后海马神经胶质细胞和神经元的反应性转录组变化可能提供一些启示。为了诱导 TLE,向小鼠的海马 CA1 区立体注射了 200 毫升的凯尼酸(KA),注射后观察 7 天。采用单细胞RNA测序(SCRNA-seq)、单核RNA测序(SnRNA-seq)和基于Xenium的空间转录组学分析来评估神经胶质细胞和神经元中mRNA表达的变化。从 ScRNA-seq 和 SnRNA-seq 数据中识别出了 31,390 个神经胶质细胞和 48,221 个神经元细胞核。对差异表达基因(DEGs)的分析表明,患有TLE的小鼠海马细胞中的转录组发生了显著变化,影响了数百至数千个mRNA及其信号通路。富集分析表明,在TLE海马中,应激和炎症通路显著激活,而与轴突发育和神经支持相关的通路则受到抑制。Xenium 分析显示了所有 247 个基因在小鼠大脑切片中的表达情况,揭示了它们在 27 种细胞类型中的空间分布。对通过三种测序技术确定的DEGs进行综合分析后发现,Spp1、Trem2和Cd68在所有神经胶质细胞类型和Xenium数据中上调;Penk、Sorcs3和Plekha2在所有神经元细胞类型和Xenium数据中上调;Tle4和Sipa1l3在所有神经胶质细胞类型和Xenium数据中下调。本研究建立了TLE小鼠海马的高分辨率单细胞转录组图谱,揭示了驱动TLE相关炎症激活和细胞相互作用改变的潜在内在机制。这些发现为进一步探索HS的发展和癫痫发生提供了宝贵的见解。
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引用次数: 0
Updates on CAR T cell therapy in multiple myeloma 多发性骨髓瘤 CAR T 细胞疗法的最新进展
IF 11.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-12 DOI: 10.1186/s40364-024-00634-5
Fatemeh Nasiri, Yasaman Asaadi, Farzaneh Mirzadeh, Shahrokh Abdolahi, Sedigheh Molaei, Somayeh Piri Gavgani, Fatemeh Rahbarizadeh
Multiple myeloma (MM) is a hematological cancer characterized by the abnormal proliferation of plasma cells. Initial treatments often include immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and monoclonal antibodies (mAbs). Despite salient progress in diagnosis and treatment, most MM patients typically have a median life expectancy of only four to five years after starting treatment. In recent developments, the success of chimeric antigen receptor (CAR) T-cells in treating B-cell malignancies exemplifies a new paradigm shift in advanced immunotherapy techniques with promising therapeutic outcomes. Ide-cel and cilta-cel stand as the only two FDA-approved BCMA-targeted CAR T-cells for MM patients, a recognition achieved despite extensive preclinical and clinical research efforts in this domain. Challenges remain regarding certain aspects of CAR T-cell manufacturing and administration processes, including the lack of accessibility and durability due to T-cell characteristics, along with expensive and time-consuming processes limiting health plan coverage. Moreover, MM features, such as tumor antigen heterogeneity, antigen presentation alterations, complex tumor microenvironments, and challenges in CAR-T trafficking, contribute to CAR T-cell exhaustion and subsequent therapy relapse or refractory status. Additionally, the occurrence of adverse events such as cytokine release syndrome, neurotoxicity, and on-target, off-tumor toxicities present obstacles to CAR T-cell therapies. Consequently, ongoing CAR T-cell trials are diligently addressing these challenges and barriers. In this review, we provide an overview of the effectiveness of currently available CAR T-cell treatments for MM, explore the primary resistance mechanisms to these treatments, suggest strategies for improving long-lasting remissions, and investigate the potential for combination therapies involving CAR T-cells.
多发性骨髓瘤(MM)是一种以浆细胞异常增殖为特征的血液肿瘤。初始治疗通常包括免疫调节药物(IMiDs)、蛋白酶体抑制剂(PIs)和单克隆抗体(mAbs)。尽管在诊断和治疗方面取得了显著进展,但大多数 MM 患者在开始治疗后的中位预期寿命通常只有四到五年。最近,嵌合抗原受体(CAR)T 细胞在治疗 B 细胞恶性肿瘤方面取得了成功,这体现了先进免疫疗法技术的新范式转变,并带来了良好的治疗效果。Ide-cel和cilta-cel是美国食品及药物管理局批准用于治疗MM患者的仅有两种以BCMA为靶点的CAR T细胞。CAR T 细胞制造和管理流程的某些方面仍面临挑战,包括 T 细胞特性导致的可及性和耐久性不足,以及昂贵、耗时的流程限制了医疗计划的覆盖范围。此外,MM 的特征,如肿瘤抗原异质性、抗原递呈改变、复杂的肿瘤微环境以及 CAR-T 移植过程中的挑战,都会导致 CAR T 细胞耗竭以及随后的治疗复发或难治性状态。此外,细胞因子释放综合征、神经毒性、靶上和瘤外毒性等不良反应的发生也是 CAR T 细胞疗法的障碍。因此,正在进行的 CAR T 细胞试验正在努力应对这些挑战和障碍。在这篇综述中,我们概述了目前可用的CAR T细胞疗法对MM的疗效,探讨了这些疗法的主要耐药机制,提出了改善长期缓解的策略,并研究了CAR T细胞联合疗法的潜力。
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引用次数: 0
Spatial resolved transcriptomics reveals distinct cross-talk between cancer cells and tumor-associated macrophages in intrahepatic cholangiocarcinoma 空间分辨转录组学揭示了肝内胆管癌中癌细胞与肿瘤相关巨噬细胞之间独特的交叉对话
IF 11.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-11 DOI: 10.1186/s40364-024-00648-z
Zhao-Ru Dong, Meng-Ya Zhang, Ling-Xin Qu, Jie Zou, Yong-Heng Yang, Yun-Long Ma, Chun-Cheng Yang, Xue-Lei Cao, Li-Yuan Wang, Xiao-Lu Zhang, Tao Li
Multiple studies have shown that tumor-associated macrophages (TAMs) promote cancer initiation and progression. However, the reprogramming of macrophages in the tumor microenvironment (TME) and the cross-talk between TAMs and malignant subclones in intrahepatic cholangiocarcinoma (iCCA) has not been fully characterized, especially in a spatially resolved manner. Deciphering the spatial architecture of variable tissue cellular components in iCCA could contribute to the positional context of gene expression containing information pathological changes and cellular variability. Here, we applied spatial transcriptomics (ST) and digital spatial profiler (DSP) technologies with tumor sections from patients with iCCA. The results reveal that spatial inter- and intra-tumor heterogeneities feature iCCA malignancy, and tumor subclones are mainly driven by physical proximity. Tumor cells with TME components shaped the intra-sectional heterogenetic spatial architecture. Macrophages are the most infiltrated TME component in iCCA. The protein trefoil factor 3 (TFF3) secreted by the malignant subclone can induce macrophages to reprogram to a tumor-promoting state, which in turn contributes to an immune-suppressive environment and boosts tumor progression. In conclusion, our description of the iCCA ecosystem in a spatially resolved manner provides novel insights into the spatial features and the immune suppressive landscapes of TME for iCCA.
多项研究表明,肿瘤相关巨噬细胞(TAMs)会促进癌症的发生和发展。然而,在肝内胆管癌(iCCA)中,巨噬细胞在肿瘤微环境(TME)中的重编程以及TAMs和恶性亚克隆之间的交叉对话尚未得到充分描述,特别是以空间分辨的方式。破译 iCCA 中可变组织细胞成分的空间结构有助于了解含有病理变化和细胞可变性信息的基因表达的位置背景。在此,我们对 iCCA 患者的肿瘤切片应用了空间转录组学(ST)和数字空间轮廓仪(DSP)技术。结果表明,iCCA 恶性肿瘤具有瘤间和瘤内空间异质性的特点,肿瘤亚克隆主要由物理邻近性驱动。具有TME成分的肿瘤细胞形成了节段内异质性空间结构。巨噬细胞是iCCA中浸润最多的TME成分。恶性亚克隆分泌的蛋白质三叶因子3(TFF3)可诱导巨噬细胞重编程为肿瘤促进状态,进而形成免疫抑制环境并促进肿瘤进展。总之,我们以空间分辨的方式对 iCCA 生态系统进行的描述,为我们了解 iCCA TME 的空间特征和免疫抑制景观提供了新的视角。
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引用次数: 0
Global, regional, and national burden of acute myeloid leukemia, 1990–2021: a systematic analysis for the global burden of disease study 2021 1990-2021 年急性髓性白血病的全球、地区和国家负担:2021 年全球疾病负担研究的系统分析
IF 11.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-11 DOI: 10.1186/s40364-024-00649-y
Yeming Zhou, Guiqin Huang, Xiaoya Cai, Ying Liu, Bingxin Qian, Dengju Li
Acute myeloid leukemia (AML), as the most common subtype of leukemia in adults, is characterised by rapid progression and poor prognosis. In the context of the rapid development of medical technology and the complexity of social factors, a detailed report describing the latest epidemiological patterns of AML is important for decision makers to allocate healthcare resources effectively. Our research utilized the latest data sourced from the Global Burden of Disease (GBD) 2021. To delineate the burden of AML, we comprehensively described the incidence, deaths, disability-adjusted life years (DALYs), and the associated age-standardized rates per 100,000 persons (ASR) spanning from 1990 to 2021 stratifies according to age, sex, socio-demographic index (SDI), and nationality. Additionally, we extracted and analyzed data about the risk factors that contribute to AML-related deaths and DALYs. According to our study, the incidence of AML has continued to rise globally from 79,372 in 1990 to 144,645 in 2021 and AML affected the male and the elderly populations disproportionately. Furthermore, there was a significant positive correlation between the burden of AML and the SDI value. Developed nations generally exhibited higher age-standardized incidence rate, age-standardized death rate, and age-standardized disability-adjusted life year rate than the developing nations. We also analyzed the prevalence of smoking, high body mass index, and occupational benzene and formaldehyde exposure in the AML population in different SDI regions. Moreover, smoking and high body mass index were more prevalent in developed countries, whereas occupational exposure to these chemicals was the predominant risk factor in developing countries. The global burden of AML has increased over the past 32 years, with rising morbidity and mortality. The incidence of AML is differentially distributed across different SDI countries or regions. AML incidence is higher in the elderly and in men. The proportions of smoking, high body mass index, and occupational exposure to benzene and formaldehyde varied by region. The findings highlight the need for region-specific prevention and call for future research on preventive strategies and new treatments to lower AML incidence and improve patient outcomes.
急性髓性白血病(AML)是成人白血病中最常见的亚型,其特点是病情发展快、预后差。在医疗技术飞速发展、社会因素错综复杂的背景下,一份详细描述急性髓细胞白血病最新流行病学模式的报告对于决策者有效分配医疗资源非常重要。我们的研究利用了来自《2021 年全球疾病负担》(GBD)的最新数据。为了描述急性髓细胞性白血病的负担,我们全面描述了从 1990 年到 2021 年期间,根据年龄、性别、社会人口指数(SDI)和国籍分层的发病率、死亡率、残疾调整生命年(DALYs)以及相关的每 10 万人年龄标准化比率(ASR)。此外,我们还提取并分析了导致急性髓细胞性白血病相关死亡和残疾调整寿命年数的风险因素数据。根据我们的研究,全球急性髓细胞性白血病的发病率从 1990 年的 79,372 例持续上升至 2021 年的 144,645 例,而急性髓细胞性白血病对男性和老年人群的影响尤为严重。此外,急性髓细胞性白血病的负担与 SDI 值之间存在明显的正相关。发达国家的年龄标准化发病率、年龄标准化死亡率和年龄标准化残疾调整生命年率普遍高于发展中国家。我们还分析了不同 SDI 地区急性髓细胞性白血病人群的吸烟率、高体重指数以及职业苯和甲醛暴露。此外,吸烟和高体重指数在发达国家更为普遍,而职业性接触这些化学品则是发展中国家的主要风险因素。在过去的 32 年中,急性髓细胞性白血病的全球负担不断加重,发病率和死亡率不断上升。急性髓细胞性白血病的发病率在不同的 SDI 国家或地区有不同的分布。老年人和男性的急性髓细胞性白血病发病率较高。吸烟、体重指数高以及职业接触苯和甲醛的比例因地区而异。研究结果凸显了针对不同地区进行预防的必要性,并呼吁今后研究预防策略和新的治疗方法,以降低急性髓细胞性白血病的发病率并改善患者的预后。
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引用次数: 0
Gene therapy for polygenic or complex diseases. 多基因或复杂疾病的基因治疗。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-04 DOI: 10.1186/s40364-024-00618-5
Tingting Wu, Yu Hu, Liang V Tang

Gene therapy utilizes nucleic acid drugs to treat diseases, encompassing gene supplementation, gene replacement, gene silencing, and gene editing. It represents a distinct therapeutic approach from traditional medications and introduces novel strategies for genetic disorders. Over the past two decades, significant advancements have been made in the field of gene therapy, leading to the approval of various gene therapy drugs. Gene therapy was initially employed for treating genetic diseases and cancers, particularly monogenic conditions classified as orphan diseases due to their low prevalence rates; however, polygenic or complex diseases exhibit higher incidence rates within populations. Extensive research on the etiology of polygenic diseases has unveiled new therapeutic targets that offer fresh opportunities for their treatment. Building upon the progress achieved in gene therapy for monogenic diseases and cancers, extending its application to polygenic or complex diseases would enable targeting a broader range of patient populations. This review aims to discuss the strategies of gene therapy, methods of gene editing (mainly CRISPR-CAS9), and carriers utilized in gene therapy, and highlight the applications of gene therapy in polygenic or complex diseases focused on applications that have either entered clinical stages or are currently undergoing clinical trials.

基因疗法利用核酸药物治疗疾病,包括基因补充、基因替换、基因沉默和基因编辑。它代表了一种有别于传统药物的治疗方法,并引入了治疗遗传疾病的新策略。过去二十年来,基因治疗领域取得了重大进展,各种基因治疗药物也因此获得批准。基因疗法最初用于治疗遗传病和癌症,尤其是因发病率低而被列为孤儿病的单基因疾病;然而,多基因或复杂疾病在人群中的发病率较高。对多基因疾病病因的广泛研究揭示了新的治疗靶点,为其治疗提供了新的机遇。在基因疗法治疗单基因疾病和癌症取得进展的基础上,将其应用扩展到多基因或复杂疾病,将能针对更广泛的患者群体。本综述旨在讨论基因治疗的策略、基因编辑方法(主要是 CRISPR-CAS9)和基因治疗中使用的载体,并重点介绍基因治疗在多基因或复杂疾病中的应用,重点关注已进入临床阶段或正在进行临床试验的应用。
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引用次数: 0
Abscopal effect: from a rare phenomenon to a new frontier in cancer therapy. 缺影效应:从罕见现象到癌症治疗的新领域。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-04 DOI: 10.1186/s40364-024-00628-3
Xueying Wang, Haoyu Zhang, XinZhang, Yong Liu

Radiotherapy (RT) controls local lesions, meantime it has the capability to induce systemic response to inhibit distant, metastatic, non-radiated tumors, which is referred to as the "abscopal effect". It is widely recognized that radiotherapy can stimulate systemic immune response. This provides a compelling theoretical basis for the combination of immune therapy combined with radiotherapy(iRT). Indeed, this phenomenon has also been observed in clinical treatment, bringing significant clinical benefits to patients, and a series of basic studies are underway to amplify this effect. However, the molecular mechanisms of immune response induced by RT, determination of the optimal treatment regimen for iRT, and how to amplify the abscopal effect. In order to amplify and utilize this effect in clinical management, these key issues require to be well addressed; In this review, we comprehensively summarize the growing consensus and emphasize the emerging limitations of enhancing the abscopal effect with radiotherapy or immunotherapy. Finally, we discuss the prospects and barriers to the current clinical translational applications.

放疗(RT)可控制局部病变,同时还能诱导全身反应,抑制远处未放疗的转移性肿瘤,这就是所谓的 "脱落效应"。人们普遍认为,放疗可以刺激全身免疫反应。这为免疫疗法联合放疗(iRT)提供了令人信服的理论基础。事实上,在临床治疗中也观察到了这一现象,并为患者带来了显著的临床获益,目前正在进行一系列基础研究以扩大这一效应。然而,RT 诱导免疫反应的分子机制、iRT 最佳治疗方案的确定以及如何放大腹水效应等问题,都是研究的重点。在这篇综述中,我们全面总结了日益增长的共识,并强调了放疗或免疫疗法在增强腹水效应方面新出现的局限性。最后,我们讨论了目前临床转化应用的前景和障碍。
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引用次数: 0
Infiltrating treg reprogramming in the tumor immune microenvironment and its optimization for immunotherapy. 肿瘤免疫微环境中的浸润树突重编程及其对免疫疗法的优化。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-04 DOI: 10.1186/s40364-024-00630-9
Zhaokai Zhou, Jiaxin Xu, Shutong Liu, Yingying Lv, Ruiqi Zhang, Xing Zhou, Yuyuan Zhang, Siyuan Weng, Hui Xu, Yuhao Ba, Anning Zuo, Xinwei Han, Zaoqu Liu

Immunotherapy has shown promising anti-tumor effects across various tumors, yet it encounters challenges from the inhibitory tumor immune microenvironment (TIME). Infiltrating regulatory T cells (Tregs) are important contributors to immunosuppressive TIME, limiting tumor immunosurveillance and blocking effective anti-tumor immune responses. Although depletion or inhibition of systemic Tregs enhances the anti-tumor immunity, autoimmune sequelae have diminished expectations for the approach. Herein, we summarize emerging strategies, specifically targeting tumor-infiltrating (TI)-Tregs, that elevate the capacity of organisms to resist tumors by reprogramming their phenotype. The regulatory mechanisms of Treg reprogramming are also discussed as well as how this knowledge could be utilized to develop novel and effective cancer immunotherapies.

免疫疗法在各种肿瘤中都显示出良好的抗肿瘤效果,但它也遇到了来自抑制性肿瘤免疫微环境(TIME)的挑战。浸润性调节性 T 细胞(Tregs)是造成免疫抑制性 TIME 的重要因素,可限制肿瘤免疫监视并阻断有效的抗肿瘤免疫反应。虽然消耗或抑制全身性 Tregs 能增强抗肿瘤免疫力,但自身免疫后遗症降低了人们对这种方法的期望。在此,我们总结了新出现的策略,特别是针对肿瘤浸润(TI)-Tregs的策略,这些策略通过重编程表型来提高生物体抵抗肿瘤的能力。我们还讨论了Treg重编程的调控机制,以及如何利用这些知识开发新型有效的癌症免疫疗法。
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引用次数: 0
Metabolic reprogramming and immune evasion: the interplay in the tumor microenvironment. 代谢重编程和免疫逃避:肿瘤微环境中的相互作用。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-03 DOI: 10.1186/s40364-024-00646-1
Haixia Zhang, Shizhen Li, Dan Wang, Siyang Liu, Tengfei Xiao, Wangning Gu, Hongmin Yang, Hui Wang, Minghua Yang, Pan Chen

Tumor cells possess complex immune evasion mechanisms to evade immune system attacks, primarily through metabolic reprogramming, which significantly alters the tumor microenvironment (TME) to modulate immune cell functions. When a tumor is sufficiently immunogenic, it can activate cytotoxic T-cells to target and destroy it. However, tumors adapt by manipulating their metabolic pathways, particularly glucose, amino acid, and lipid metabolism, to create an immunosuppressive TME that promotes immune escape. These metabolic alterations impact the function and differentiation of non-tumor cells within the TME, such as inhibiting effector T-cell activity while expanding regulatory T-cells and myeloid-derived suppressor cells. Additionally, these changes lead to an imbalance in cytokine and chemokine secretion, further enhancing the immunosuppressive landscape. Emerging research is increasingly focusing on the regulatory roles of non-tumor cells within the TME, evaluating how their reprogrammed glucose, amino acid, and lipid metabolism influence their functional changes and ultimately aid in tumor immune evasion. Despite our incomplete understanding of the intricate metabolic interactions between tumor and non-tumor cells, the connection between these elements presents significant challenges for cancer immunotherapy. This review highlights the impact of altered glucose, amino acid, and lipid metabolism in the TME on the metabolism and function of non-tumor cells, providing new insights that could facilitate the development of novel cancer immunotherapies.

肿瘤细胞拥有复杂的免疫逃避机制,主要通过代谢重编程来逃避免疫系统的攻击,从而显著改变肿瘤微环境(TME),调节免疫细胞的功能。当肿瘤具有足够的免疫原性时,它就能激活细胞毒性 T 细胞来靶向摧毁肿瘤。然而,肿瘤会通过操纵其代谢途径,尤其是葡萄糖、氨基酸和脂质代谢,来创造一种免疫抑制性 TME,从而促进免疫逃逸。这些代谢改变会影响 TME 内非肿瘤细胞的功能和分化,如抑制效应 T 细胞的活性,同时扩大调节性 T 细胞和髓源性抑制细胞。此外,这些变化还会导致细胞因子和趋化因子分泌失衡,进一步加剧免疫抑制。新的研究正越来越多地关注非肿瘤细胞在TME中的调节作用,评估它们重新编程的葡萄糖、氨基酸和脂质代谢如何影响其功能变化,并最终帮助肿瘤免疫逃避。尽管我们对肿瘤细胞和非肿瘤细胞之间错综复杂的新陈代谢相互作用了解不全面,但这些元素之间的联系给癌症免疫疗法带来了重大挑战。本综述强调了TME中葡萄糖、氨基酸和脂质代谢的改变对非肿瘤细胞代谢和功能的影响,提供了有助于开发新型癌症免疫疗法的新见解。
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引用次数: 0
Soluble immune checkpoint molecules in cancer risk, outcomes prediction, and therapeutic applications. 癌症风险、结果预测和治疗应用中的可溶性免疫检查点分子。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-02 DOI: 10.1186/s40364-024-00647-0
Lin Chen, Yuqing Chao, Wenjing Li, Zhixia Wu, Qinchuan Wang

Immunotherapy has emerged as a pivotal modality in cancer treatment, with immune checkpoint inhibitors effectively combating malignancies by impeding crucial pathways within the immune system and stimulating patients' immune responses. Soluble forms of immune checkpoints exhibit a remarkable diversity and can be readily tracked in circulation, holding immense potential as biomarkers for cancer treatment. An increasing number of studies focused on soluble immune checkpoints in cancer have emerged thanks to technological advancements. In this systematic review, we comprehensively summarized the recent studies on soluble immune checkpoints in human cancer risk prediction, outcome prediction, therapeutic applications, and potential molecular mechanisms, which demonstrated the promising future of soluble immune checkpoints in clinical applications. The clinical relevance of soluble immune checkpoints has been recognized in multiple cancers, yet the therapeutic applications and mechanisms remain obscure. Interpreting the impacts and mechanisms of soluble immune checkpoints could shed a light on the novel strategies of cancer screening, treatments, and outcome prediction.

免疫疗法已成为癌症治疗的一种重要方式,免疫检查点抑制剂通过阻碍免疫系统内的关键通路并刺激患者的免疫反应,从而有效对抗恶性肿瘤。免疫检查点的可溶性形式呈现出显著的多样性,并可在血液循环中随时追踪,具有作为癌症治疗生物标记物的巨大潜力。由于技术的进步,越来越多关注癌症中可溶性免疫检查点的研究涌现出来。在这篇系统综述中,我们全面总结了近期有关可溶性免疫检查点在人类癌症风险预测、结果预测、治疗应用和潜在分子机制方面的研究,展示了可溶性免疫检查点在临床应用中的广阔前景。可溶性免疫检查点在多种癌症中的临床意义已得到认可,但其治疗应用和机制仍不明确。解读可溶性免疫检查点的影响和机制可为癌症筛查、治疗和结果预测的新策略提供启示。
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引用次数: 0
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Biomarker Research
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