对移植与宿主疾病的新疗法,重点是细胞疗法
Robert Zeiser1, Olle Ringden2, Behnam Sadeghi2
1Department of Medicine at the University of Freiburg, Freiburg, Germany.
Frontiers in immunology
|October 23, 2023
概括
在干细胞移植后,决定性干细胞 (DSC) 在治疗类固醇耐药性急性移植对宿主疾病 (GVHD) 中表现有前途. 这种新型细胞疗法比现有的治疗这种严重并发症的治疗方法提供了更好的生存率.
科学领域:
- 免疫学 免疫学 免疫学
- 细胞疗法细胞疗法
- 血液学 血液学 血液学
背景情况:
- 移植与宿主疾病 (GVHD) 是异构造血细胞干细胞移植 (HSCT) 后的一个重大并发症,导致大量的发病率和死亡率.
- 类固醇耐药性急性GVHD (SR-aGVHD) 发生在约40%的患者中,预后不佳,治疗选择有限.
- 目前SR-aGVHD的管理策略缺乏共识,突出强调迫切需要有效的治疗干预措施来改善患者的生存率.
研究的目的:
- 审查GVHD的特征,病理生理学和治疗方法,重点关注最近细胞疗法的进展.
- 评估决定性树皮细胞 (DSC) 作为急性GVHD的新型细胞疗法的疗效和安全性,特别是类固醇耐药病例.
- 介绍卡罗林斯卡研究所关于DSC治疗结果的初步数据,并讨论即将进行的临床试验.
主要方法:
- 审查关于GVHD病理生理学和治疗方式的现有文献.
- 在卡罗林斯卡研究所对重度急性GVHD患者的临床数据分析,这些患者接受了胎盘衍生DSC (补充了白蛋白或AB血) 的治疗.
- 与接受DSC治疗的患者和接受介质细胞侧膜细胞的对照组之间的生存率的比较.
主要成果:
- 在严重急性GVHD患者中,来自胎盘的DSC显示出有希望的1年生存率 (76%与白蛋白,47%与AB血).
- 在耐固醇性急性GVHD患者中,DSCs显示了与中介细胞 stromal 细胞 (20%) 相比的更好的生存率 (73%与白蛋白).
- 副作用仅归因于HSCT和GVHD并发症,而不是DSC干预.
结论:
- 决定性树皮细胞代表了一种新且有前途的细胞疗法,用于治疗耐固醇性急性GVHD.
- DSCs提供了一个潜在的治疗策略,以改善SR-aGVHD预后不佳的患者的生存结果.
- 一项即将进行的第二阶段多中心研究将进一步评估静脉DSC治疗在SR-aGVHD患者更大的队列中的疗效和安全性.
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