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Next generation therapies change the landscape in melanoma. 下一代疗法改变了黑素瘤的现状。
Pub Date : 2011-01-01 Epub Date: 2011-04-01 DOI: 10.3410/M3-8
Keith T Flaherty
Melanoma is among the leading causes of years of life lost due to cancer. Current chemotherapy and cytokine-based immunotherapy approaches benefit only a small percentage of patients with advanced disease. However, the recent discovery of mutations in the gene encoding the serine-threonine kinase B-RAF (BRAF) raises the possibility that oncogene-targeted therapy may provide a new point of vulnerability. In parallel, a deeper understanding of the molecular mechanisms underlying antitumor T-cell activation and tolerance has provided a basis for developing therapies targeted against these processes. Results from an early phase trial with a BRAF inhibitor and a phase III trial with a novel agent that activates T cells have radically altered the prospects for improving outcomes for patients with this historically treatment-refractory disease.
黑色素瘤是癌症导致寿命缩短的主要原因之一。目前的化疗和基于细胞因子的免疫治疗方法仅使一小部分晚期疾病患者受益。然而,最近发现的编码丝氨酸-苏氨酸激酶B-RAF (BRAF)的基因突变,提出了癌基因靶向治疗可能提供新的易感点的可能性。同时,对抗肿瘤t细胞活化和耐受性的分子机制的深入了解为开发针对这些过程的治疗方法提供了基础。BRAF抑制剂的早期试验和激活T细胞的新型药物的III期试验的结果从根本上改变了这种历史上难治性疾病患者改善预后的前景。
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引用次数: 7
Vaccines for invasive fungal infections. 侵袭性真菌感染的疫苗。
Pub Date : 2011-01-01 Epub Date: 2011-07-01 DOI: 10.3410/M3-13
Brad Spellberg

Morbidity and mortality from invasive fungal infections remain unacceptably high despite availability of new antifungal agents, underscoring the need for more effective preventative strategies. Due to our enhanced understanding of the host defense and pathogenetic mechanisms that lead to invasive fungal infections, it should be feasible to develop vaccines targeting these infections. A common immunological theme across many vaccine candidates for invasive fungal infections has been the need to activate a cell-based, pro-inflammatory, Th1 or Th17 immune response to improve phagocytic killing of the fungi. Since neutralization of virulence factor functions has not been required for many active vaccines to function, the antigenic repertoire available for testing should not be limited to virulence factors. With expansion of our fundamental understanding of the immunology of fungal infections, the biggest barrier to development of fungal vaccines is the lack of available capital to translate discoveries made at the bench into biological agents used at the bedside. Continued education on the importance and feasibility of vaccination for such infections, combined with continued development of vaccine antigens and adjuvants, is necessary.

尽管有新的抗真菌药物可用,侵袭性真菌感染的发病率和死亡率仍然高得令人无法接受,强调需要更有效的预防策略。由于我们对导致侵袭性真菌感染的宿主防御和致病机制的理解增强,开发针对这些感染的疫苗应该是可行的。在侵袭性真菌感染的许多候选疫苗中,一个共同的免疫学主题是需要激活基于细胞的、促炎的、Th1或Th17免疫反应,以改善真菌的吞噬杀伤。由于许多活疫苗并不需要毒力因子功能的中和,因此可供检测的抗原库不应局限于毒力因子。随着我们对真菌感染免疫学的基本理解的扩大,真菌疫苗开发的最大障碍是缺乏可用的资金来将实验室的发现转化为床边使用的生物制剂。有必要继续开展关于此类感染接种疫苗的重要性和可行性的教育,同时继续开发疫苗抗原和佐剂。
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引用次数: 33
Advancements in adeno-associated viral gene therapy approaches: exploring a new horizon. 腺相关病毒基因治疗方法的进展:探索新的视野。
Pub Date : 2011-01-01 Epub Date: 2011-09-01 DOI: 10.3410/M3-17
Caroline J Aalbers, Paul P Tak, Margriet J Vervoordeldonk

Gene therapy is a promising new therapeutic strategy that has been explored in a wide variety of diseases, ranging from cancer to hemophilia, and ocular disorders to autoimmune diseases, among others. Proof of concept of gene transfer approaches has been shown in over 100 studies of animal models of disease, although only a few are under development for clinical application. The US Food and Drug Administration and the European Medicines Agency have not approved any viral human gene therapy products for sale so far, but the amount of gene-related research and development occurring in the United States and Europe continues to grow at a fast rate. This review summarizes the current status of developments in the field of viral gene therapy using adeno-associated virus as a vector, with a special focus on arthritis. For rheumatoid arthritis, and to a lesser extent for other immune-related inflammatory disorders, several cell and gene transfer approaches have been investigated at the preclinical level and a few have been implemented in clinical trials. Finally, both the potential and the hurdles that are faced during development of a viral gene therapy through to its clinical application are discussed.

基因治疗是一种很有前景的新治疗策略,已经在多种疾病中得到了探索,从癌症到血友病,从眼部疾病到自身免疫性疾病,等等。基因转移方法的概念已在100多项疾病动物模型研究中得到证明,尽管只有少数正在开发用于临床应用。到目前为止,美国食品和药物管理局和欧洲药品管理局还没有批准任何病毒人类基因治疗产品的销售,但在美国和欧洲发生的基因相关研究和开发的数量继续以快速的速度增长。本文综述了以腺相关病毒为载体的病毒基因治疗领域的发展现状,并以关节炎为重点。对于类风湿性关节炎,以及较小程度的其他免疫相关炎症性疾病,已经在临床前水平研究了几种细胞和基因转移方法,其中一些已在临床试验中实施。最后,讨论了病毒基因治疗在发展到临床应用过程中所面临的潜力和障碍。
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引用次数: 28
Illuminating the deleterious effects of light at night. 照亮了夜间光线的有害影响。
Pub Date : 2011-01-01 Epub Date: 2011-09-01 DOI: 10.3410/M3-18
Laura K Fonken, Randy J Nelson

Technological advances, while providing many benefits, often create circumstances that differ from the conditions in which we evolved. With the wide-spread adoption of electrical lighting during the 20(th) century, humans became exposed to bright and unnatural light at night for the first time in their evolutionary history. Electrical lighting has led to the wide-scale practice of 24-hour shift-work and has meant that what were once just "daytime" activities now run throughout the night; in many ways Western society now functions on a 24-hour schedule. Recent research suggests that this gain in freedom to function throughout the night may also come with significant repercussions. Disruption of our naturally evolved light and dark cycles can result in a wide range of physiological and behavioral changes with potentially serious medical implications. In this article we will discuss several mechanisms through which light at night may exert its effects on cancer, mood, and obesity, as well as potential ways to ameliorate the impact of light at night.

技术进步虽然带来了许多好处,但也常常创造出与我们进化时不同的环境。随着20世纪电气照明的广泛采用,人类在其进化史上第一次在夜间接触到明亮而不自然的光。电气照明导致了24小时轮班工作的大规模实施,这意味着曾经只是“白天”的活动现在在整个晚上都在进行;西方社会在很多方面都是24小时工作制。最近的研究表明,这种夜间活动自由的增加也可能带来重大影响。破坏我们自然进化的明暗周期会导致广泛的生理和行为变化,并可能产生严重的医学影响。在这篇文章中,我们将讨论夜间光线对癌症、情绪和肥胖的影响的几种机制,以及改善夜间光线影响的潜在方法。
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引用次数: 75
Alzheimer's - Looking beyond plaques. 阿尔茨海默氏症——超越斑块。
Pub Date : 2011-01-01 Epub Date: 2011-12-01 DOI: 10.3410/M3-24
W Sue T Griffin

Mounting evidence shows that inflammation plays a critical role in causing Alzheimer's disease. Over the last few decades we have gone from a situation where inflammation was generally believed to have no role in the disease to the current picture where chronic activation of IL-1 inflammation has been shown to account for many of the hallmarks of the disease. This review is a personal account of the quest to prove that inflammation plays a critical role in causing Alzheimer's disease.

越来越多的证据表明,炎症在导致阿尔茨海默病中起着至关重要的作用。在过去的几十年里,我们已经从炎症通常被认为在疾病中没有作用的情况发展到目前的情况,即IL-1炎症的慢性激活已被证明是该疾病的许多特征。这篇综述是我个人对证明炎症在引起阿尔茨海默病中起关键作用的探索。
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引用次数: 22
Natural killer cell-based therapies. 自然杀伤细胞疗法。
Pub Date : 2011-01-01 Epub Date: 2011-05-03 DOI: 10.3410/M3-9
François Romagné, Eric Vivier

Allotransplantation of natural killer (NK) cells has been shown to be a key factor in the control and cure of at least some hematologic diseases, such as acute myeloid leukemia or pediatric acute lymphocytic leukemia. These results support the idea that stimulation of NK cells could be an important therapeutic tool in many diseases, and several such approaches are now in clinical trials, sometimes with conflicting results. In parallel, recent advances in the understanding of the molecular mechanisms governing NK-cell maturation and activity show that NK-cell effector functions are controlled by complex mechanisms that must be taken into account for optimal design of therapeutic protocols. We review here innovative protocols based on allotransplantation, use of NK-cell therapies, and use of newly available drug candidates targeting NK-cell receptors, in the light of fundamental new data on NK-cell biology.

自然杀伤(NK)细胞的同种异体移植已被证明是控制和治疗至少一些血液疾病的关键因素,如急性髓性白血病或儿童急性淋巴细胞白血病。这些结果支持了刺激NK细胞可能是许多疾病的重要治疗工具的观点,一些这样的方法现在正在临床试验中,有时结果相互矛盾。与此同时,最近对调控nk细胞成熟和活性的分子机制的研究进展表明,nk细胞效应功能是由复杂的机制控制的,在优化治疗方案时必须考虑到这些机制。我们在此回顾基于同种异体移植的创新方案,nk细胞疗法的使用,以及针对nk细胞受体的新候选药物的使用,根据nk细胞生物学的基本新数据。
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引用次数: 44
The challenge of developing universal vaccines. 开发通用疫苗的挑战。
Pub Date : 2011-01-01 Epub Date: 2011-08-01 DOI: 10.3410/M3-16
Rino Rappuoli

Antigenic variability of immunodominant antigens is a common mechanism used by pathogens to escape the immune response. Frequently, the proposed solution is a universal vaccine based on conserved antigens present on all strains of the pathogen. Indeed, a lot of progress has been made in the development of vaccines that induce broad immune responses. However, truly universal vaccines are not easy to produce and still face many challenges, mostly because in those pathogens that use antigenic variability to escape the immune response, conserved antigens have been selected by evolution to be poorly immunogenic. This review describes the progress made towards the development of vaccines inducing broad protection against Neisseria meningitidis, influenza, HIV, and Candida and the challenges of developing truly universal vaccines.

免疫优势抗原的抗原变异是病原体逃避免疫应答的常见机制。通常,建议的解决方案是基于存在于所有病原体菌株上的保守抗原的通用疫苗。事实上,在开发能引起广泛免疫反应的疫苗方面已经取得了很大进展。然而,真正的通用疫苗并不容易生产,仍然面临许多挑战,主要是因为在那些利用抗原变异性逃避免疫反应的病原体中,保守抗原已被进化选择为免疫原性差的抗原。这篇综述描述了在开发对脑膜炎奈瑟菌、流感、艾滋病毒和念珠菌具有广泛保护作用的疫苗方面取得的进展,以及开发真正通用的疫苗所面临的挑战。
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引用次数: 16
Innate inflammation and cancer: Is it time for cancer prevention? 先天炎症和癌症:是时候预防癌症了吗?
Pub Date : 2011-01-01 Epub Date: 2011-06-01 DOI: 10.3410/M3-11
Giorgio Trinchieri

Recently, studies have been reported indicating that daily aspirin treatment for a period of 5 years or longer has a significant protective effect against death by colorectal carcinoma (as has previously been shown) and also against death by other solid cancers, both gastrointestinal and otherwise. These studies have reignited interest in the possibility of using nonsteroidal anti-inflammatory drugs for cancer prevention and the possibility that the numerous recent studies identifying the molecular mechanisms of the link between inflammation and cancer may allow the identification of better drugs for cancer prevention. Cancer often originates in tissues that are chronically inflamed, either in response to infections or noninfectious inflammation. Innate inflammation receptors, proinflammatory soluble factors, and inflammation-induced transcription factors have been identified that provide an understanding of some of the molecular pathways underlying the link between inflammation and cancer. However, the important role of the innate inflammatory pathways in host defense against pathogens and tissue damage as well as the maintenance of tissue integrity and homeostasis means that additional careful studies will be needed to identify anti-inflammatory interventions with the beneficial effect of tumor prevention without unacceptable toxic side effects.

最近,有研究报告表明,每天服用阿司匹林5年或更长时间,对预防结直肠癌造成的死亡(如先前所显示的)和其他实体癌症(包括胃肠道和其他癌症)造成的死亡具有显著的保护作用。这些研究重新点燃了人们对使用非甾体抗炎药预防癌症的可能性的兴趣,以及最近许多研究确定炎症和癌症之间联系的分子机制的可能性,这些研究可能会发现更好的预防癌症的药物。癌症通常起源于慢性炎症的组织,要么是对感染的反应,要么是非感染性炎症。先天炎症受体、促炎可溶性因子和炎症诱导的转录因子已经被确定,它们提供了炎症和癌症之间联系的一些分子途径的理解。然而,先天炎症通路在宿主防御病原体和组织损伤以及维持组织完整性和体内平衡中的重要作用意味着需要进一步的仔细研究来确定抗炎干预措施,既能预防肿瘤,又不会产生不可接受的毒副作用。
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引用次数: 35
Resolvins and inflammatory pain. 缓解炎症性疼痛。
Pub Date : 2011-01-01 Epub Date: 2011-10-03 DOI: 10.3410/M3-19
Claudia Sommer, Frank Birklein

Resolvins are a group of molecules derived from omega-3 fatty acids. They are part of a biochemical program that allows inflamed tissues to return to homeostasis once the need for the inflammatory response is over. Resolvins act in very low dose ranges in vitro and in vivo. New data suggest that they might have the potential to become very potent analgesic drugs in inflammatory pain.

分解蛋白是一组来源于omega-3脂肪酸的分子。它们是生物化学程序的一部分,一旦炎症反应的需要结束,就可以让发炎的组织恢复到体内平衡。Resolvins在体内和体外的作用剂量都很低。新的数据表明,它们可能有潜力成为治疗炎症性疼痛的有效镇痛药物。
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引用次数: 16
ALK and NSCLC: Targeted therapy with ALK inhibitors. ALK 和 NSCLC:ALK 抑制剂的靶向治疗。
Pub Date : 2011-01-01 Epub Date: 2011-11-01 DOI: 10.3410/M3-21
Bengt Hallberg, Ruth H Palmer

For many years treatment for advanced or metastatic non-small cell lung cancer (NSCLC) has employed chemotherapy regimens for patient care, with limited effect. Five-year survival rates for these patients are not encouraging. However, for a subgroup of these patients, there have been radical changes over recent years. Our understanding of the basic pathology behind NSCLC at the molecular level has offered up a host of new molecularly targeted therapies, which are revolutionizing this area of cancer care. Results from recent clinical trials provide hope for NSCLC patients harboring oncogenic translocations involving the anaplastic lymphoma kinase (ALK) receptor tyrosine kinase. Just as inhibition of the breakpoint cluster region-ABL complex has changed the face of chronic myeloid leukemia diagnosis, oncogenic ALK fusions offer a step forward in the diagnosis and treatment of ALK-positive NSCLC. This article discusses the current knowledge and potential implications concerning ALK inhibitors and NSCLC.

多年来,晚期或转移性非小细胞肺癌(NSCLC)的治疗一直采用化疗方案,但效果有限。这些患者的五年生存率并不乐观。然而,对于这些患者中的一个亚群来说,近年来发生了翻天覆地的变化。我们在分子水平上对 NSCLC 的基本病理有了更深入的了解,这为我们提供了大量新的分子靶向疗法,从而彻底改变了这一癌症治疗领域。最近的临床试验结果为携带无性淋巴瘤激酶(ALK)受体酪氨酸激酶致癌易位的 NSCLC 患者带来了希望。正如抑制断点簇区-ABL复合物改变了慢性粒细胞白血病诊断的面貌一样,致癌ALK融合也为ALK阳性NSCLC的诊断和治疗提供了前进的一步。本文讨论了有关 ALK 抑制剂和 NSCLC 的现有知识和潜在影响。
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引用次数: 0
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