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Adoptive antifungal T cell immunotherapy - into the clinic?
过继性抗真菌T细胞免疫治疗——进入临床?

出处: Med Mycol   2010   Jun  

作者:Lehrnbecher T;Schmidt S;Koehl U;Schuster FR;Uharek L;Klingebiel T;Tramsen L

PMID:20586680

The morbidity and mortality rates of invasive fungal infection in allogeneic stem cell recipients are still unacceptably high and have not been significantly improved by alternative antifungal strategies to date. Over the last few years, rapid methods for the clinical-scale generation of functionally active and well characterized antifungal T(H)1 cells have become available. In addition, current data on the use of donor-derived virus-specific T cells in allogeneic stem cell transplantation suggest that the risk of severe adverse events, in particular the risk of graft-versus-host disease, is negligible. Therefore, adoptive antifungal immunotherapeutic strategies should be evaluated in clinical trials. However, one has to recognize that these trials are only meaningful with sufficiently large and homogenous cohorts of patients and if the settings of adoptive antifungal immunotherapy are comparable. Ultimately, the strategy of adoptively transferring antifungal immune responses might improve the outcome in hematopoietic stem cell recipients suffering from invasive fungal infection.

尽管有较多的抗真菌策略可供选择,但直到目前接受异基因造血干细胞移植的患者发生侵袭性真菌感染的发病率和死亡率仍然很高,这一状况没有得到明显改善。在过去的几年里,生产临床规模的有功能活性和良好特性的抗真菌TH1细胞的快速方法已变得可行。并且,异基因干细胞移植患者接受供者来源的病毒特异的T细胞治疗的数据资料表明它的严重不良事件尤其是移植物抗宿主病的风险是非常小的,因此应开展临床试验来对过继性抗真菌免疫治疗进行评估。然而,进行临床试验的样本必须足够大、病人资料均一以及过继性抗真菌治疗的条件必须是可比较的才有意义。最终过继性转移抗真菌免疫反应可能会改善接受造血干细胞移植患者发生侵袭性真菌感染的结局。