宿主细胞残留蛋白质对单克隆抗体药物质量影响及其质量控制

以单克隆抗体药物(monoclonal antibodies,m Abs)为代表的生物制品药物销售在不断扩大,并呈现持续上升势头,m Abs的使用为疾病治疗提供了新策略。随着m Abs使用量增大,对产品质量提出了更高要求,随着宿主细胞表达m Abs水平的不断提高,宿主细胞蛋白(host cell proteins,HCP)含量也随之增加,上下游生产工艺面临不断挑战。HCP所含蛋白质异常复杂,虽然一些HCP可能会被降解,但残留HCP仍会引起药物临床使用中的不良反应,从而影响药物的安全性和有效性。酶联免疫吸附试验(enzyme-linked immunesorbent assays,ELISAs)是目前HCP检测的重要方法之一,ELISAs可以定量检测药物中总HCP含量,但存在局限性。对正在开发的包括LC-MS/MS在内的多种分析方法进行HCP检测,将为药物工艺过程开发和验证提供更多依据。讨论了以CHO(Chinese hamster ovary,中国仓鼠卵巢)细胞系为宿主的m Abs生产中,HCP的质量控制及检测分析方法的研究进展。     

抗新型冠状病毒中和抗体药物临床研究进展北大核心CSCD

自1998年预防呼吸合胞病毒的帕利珠单抗药物上市以来,多种靶向病毒的治疗性抗体药物已成功用于感染性疾病的临床治疗。新型冠状病毒肺炎疫情暴发后,多种中和抗体药物快速进入临床研究阶段,展现出积极的治疗及预防效果,并以紧急使用授权的方式用于疫情防控。本文对抗新型冠状病毒中和抗体药物的临床进展和主要临床试验结果进行总结,以期为包括新型冠状病毒肺炎在内的新发、突发传染病中和抗体药物研发提供参考。     

支气管哮喘与呼吸道微生态关系的研究进展

人体是个巨大的生态系统,各个器官的表面附着大量的微生物,微生物群通过与宿主细胞之间的相互作用来保证机体的正常营养代谢和微生态稳定。长期以来由于呼吸道的生理功能和特性,其微生物菌群的调节作用没有引起足够重视。自“肠-肺轴”的提出,更多学者开始致力于研究呼吸道微生态,并发现一些呼吸道疾病如慢性阻塞性肺疾病、特发性肺纤维化以及支气管哮喘等的发生发展与呼吸道微生态存在一定的关系,这为进一步研究呼吸道疾病,并寻求更好的治疗方式提供新的方向和选择。本文就支气管哮喘与呼吸道微生态之间的作用关系作一综述。     

抗体治疗的重生

近年来,治疗性单克隆抗体已成为基础和临床医学研究者及企业关注的热点。目前,针对免疫检查点的治疗性抗体用于肿瘤治疗已显示出较好疗效。在微生物耐药性日益增多、全球突发传染病威胁依然存在及持续性微生物感染难以治愈的当下,抗微生物领域中的抗体治疗正在积极研发中。本文综述了抗体治疗在抗微生物感染领域中的进展,并展望了其应用前景。     

IL-17A在呼吸道慢性炎症性疾病中的研究进展

白介素-17A(IL-17A)是一种促炎因子,是IL-17细胞因子家族中的一员。该家族的细胞因子分别被命名为IL-17A至IL-17F,IL-17A是该家族中最具代表性的成员,它能够促进炎症细胞释放多种趋化因子、细胞因子和抗菌肽等,诱导中性粒细胞的聚集和增殖,是连接固有免疫和适应性免疫的桥梁。IL-17A的家族细胞因子在很多肺部过敏性、自身免疫性甚至肿瘤性疾病的发生发展和宿主防御中发挥着关键作用,在哮喘、慢性阻塞性肺病(COPD)、囊性纤维化(CF)、结节病、支气管扩张等呼吸道慢性炎症性疾病中均存在异常表达,虽然在多种疾病中未能阐明IL-17A影响疾病发展的具体作用机制,但已证明其水平与疾病的发展存在关联,这不仅为研究相关疾病的发病机制提供了新的切入点,也为其新型治疗手段的研究提供了新的思路。本文就IL-17A在呼吸道慢性炎症性疾病中的研究进展进行综述。     

治疗性抗体药物开发中IgG亚型选择

治疗性抗体药物针对不同的适应证具有专一性和有效性。目前已上市的治疗性抗体药物多是以IgG为框架开发的,并且绝大部分属于IgG1亚型。在治疗性抗体药物的开发中,由于各亚型具有不同的结构与功能,影响其理化性质、生物活性和触发效应功能的能力等,为达到期望的治疗效果并且避免不良反应,应选择适宜的抗体亚型进行抗体设计。主要综述了影响IgG亚型选择的相关因素,以及IgG1、IgG2和IgG4亚型在治疗性抗体药物开发中的应用研究,以期为治疗性抗体药物研发提供新思路。     

抗新型冠状病毒单克隆中和抗体药物研发进展*

随着新型冠状病毒肺炎(COVID-19)疫情在全球的不断蔓延,开发有效的治疗药物迫在眉睫。中和抗体作为最有希望的新型冠状病毒特异性治疗药物,已经在临床研究中展现很好的治疗效果。对抗新冠病毒单克隆中和抗体药物研发的进展、涉及的主要技术和主要临床试验结果进行了总结,以期为包括COVID-19在内的新发、突发传染病中和抗体药物研发提供参考。     

抗体药物现状及发展趋势

治疗性抗体作为一种具有独特优势的生物靶向治疗药物,已成为目前全球药物研发的热点。截止到2013年2月,已有34个治疗性抗体获得美国FDA批准上市,用于各种疾病的治疗。据统计,目前有多达350余种抗体产品正处于临床试验阶段,其中29个已进入III期临床试验。开发抗体新靶点和新适应证,研究和设计更为安全有效的新型抗体分子及抗体组合疗法,寻找生物标记指导抗体对病人的有效治疗,是当前和今后一段时期内该领域发展的主要方向。本文将综述国际抗体药物研发现状和发展趋势,并对国内抗体药物现状及发展策略予以简要陈述。     

mRNA药物的结构和临床应用

mRNA凭借其有效性、安全性和易大规模生产等特点,在预防急性传染病方面显示出巨大的潜力。mRNA代表了一个新兴的精准医学领域,几种针对传染病和癌症等疗法的mRNA在体内和体外都显示出良好效果。mRNA稳定性好、免疫原性高、不受受体主要组织相容性复合体（major histocompatibility complex, MHC）型别的限制,且mRNA理论上可实现不同目的蛋白的体内表达,这使得开发mRNA药物更具灵活性,可用于预防和治疗多种难治性或遗传性疾病。介绍了mRNA的一级结构和高级结构,综述了mRNA药物的临床应用进展,以期帮助理解mRNA的药物功能和临床应用,为mRNA药物的发展提供方向。     

人呼吸道合胞病毒疾病增强发生机制的研究进展

人呼吸道合胞病毒(Human respiratory syncytial virus,hRSV)是一种可以引起严重下呼吸道疾病的病原体,易感人群为婴幼儿、老年人及免疫力低下者。目前尚无针对RSV的疫苗和特异性抗病毒药物。20世纪60年代,用RSV的福尔马林全病毒灭活疫苗(FI-RSV)免疫的婴幼儿发生了免疫后RSV疾病增强的症状,其特征为免疫后当再次发生天然感染时会引起高热、支气管肺炎和哮喘,从而引发了更高的住院率,并最终导致两名FI-RSV免疫接种后感染RSV的幼童死亡。增强的RSV疾病(Enhanced RSV disease,ERD)主要表现为支气管周围以嗜酸性粒细胞为主的过量的单核细胞浸润以及非保护性抗体应答和细胞毒性T淋巴细胞功能异常等免疫反应。近年来,RSV研究领域正发生着重大变化,许多具有新颖设计的候选疫苗正在纷纷进入临床试验,因此我们要更加重视对ERD发生机制和临床特征的理解和分析。本文提供了对ERD发生机制的概括性描述,并对ERD作为新型候选疫苗的重要评价指标进行了讨论。     

FGF/FGFR signaling: From lung development to respiratory diseases

The fibroblast growth factor/fibroblast growth factor receptor (FGF/FGFR) signaling system regulates a variety of biological processes, including embryogenesis, angiogenesis, wound repair, tissue homeostasis, and cancer. It exerts these regulatory functions by controlling proliferation, differentiation, migration, survival, and metabolism of target cells. The morphological structure of the lung is a complex tree-like network for effective oxygen exchange, and the airway terminates in the middle and distal ends of many alveoli. FGF/FGFR signaling plays an important role in the pathophysiology of lung development and pathogenesis of various human respiratory diseases. Here, we mainly review recent advances in FGF/FGFR signaling during human lung development and respiratory diseases, including lung cancer, acute lung injury (ALI), pulmonary arterial hypertension (PAH), chronic obstructive pulmonary disease (COPD), asthma, and pulmonary fibrosis.     

The role of vitamin D in pulmonary disease: COPD,asthma, infection,and cancer

The role of vitamin D (VitD) in calcium and bone homeostasis is well described. In the last years, it has been recognized that in addition to this classical function, VitD modulates a variety of processes and regulatory systems including host defense, inflammation, immunity, and repair. VitD deficiency appears to be frequent in industrialized countries. Especially patients with lung diseases have often low VitD serum levels. Epidemiological data indicate that low levels of serum VitD is associated with impaired pulmonary function, increased incidence of inflammatory, infectious or neoplastic diseases. Several lung diseases, all inflammatory in nature, may be related to activities of VitD including asthma, COPD and cancer. The exact mechanisms underlying these data are unknown, however, VitD appears to impact on the function of inflammatory and structural cells, including dendritic cells, lymphocytes, monocytes, and epithelial cells. This review summarizes the knowledge on the classical and newly discovered functions of VitD, the molecular and cellular mechanism of action and the available data on the relationship between lung disease and VitD status.     

The pathophysiological function of peroxisome proliferator-activated receptor-γ in lung-related diseases

Research into respiratory diseases has reached a critical stage and the introduction of novel therapies is essential in combating these debilitating conditions. With the discovery of the peroxisome proliferator-activated receptor and its involvement in inflammatory responses of cardiovascular disease and diabetes, attention has turned to lung diseases and whether knowledge of this receptor can be applied to therapy of the human airways. In this article, we explore the prospect of peroxisome proliferator-activated receptor-γ as a marker and treatment focal point of lung diseases such as asthma, chronic obstructive pulmonary disorder, lung cancer and cystic fibrosis. It is anticipated that peroxisome proliferator-activated receptor-γ ligands will provide not only useful mechanistic pathway information but also a possible new wave of therapies for sufferers of chronic respiratory diseases.     

Internet-based course on pulmonary pathophysiology

A course of seven video lectures on pulmonary pathophysiology has been placed on the internet. This is a companion to the course on respiratory physiology available at http://meded.ucsd.edu/ifp/jwest/. That course dealt with normal respiratory physiology, and the new lectures are about the function of the diseased lung. The topics covered include pulmonary function tests, chronic obstructive pulmonary disease, asthma and localized airway obstruction, restrictive lung diseases, pulmonary vascular diseases, environmental or industrial lung diseases (with a short section on neoplastic and infectious diseases), and respiratory failure. Although it could be argued that PhD physiologists do not have a responsibility for teaching pathophysiology, collaborative teaching has become increasingly common in medical schools where, for example, a pulmonary block includes both normal respiratory physiology and some pulmonary pathophysiology. It is hoped that these lectures will be useful to physiologists in that setting.     

Exploring the fate of inhaled monoclonal antibody in the lung parenchyma by microdialysis

Therapeutic antibodies (Abs) are emerging as major drugs to treat respiratory diseases, and inhalation may provide substantial benefits for their delivery. Understanding the behavior of Abs after pulmonary deposition is critical for their development. We investigated the pharmacokinetics of a nebulized Ab by continuous sampling in lung parenchyma using microdialysis in non-human primates. We defined the optimal conditions for microdialysis of Ab and demonstrated that lung microdialysis of Ab is feasible over a period of several days. The concentration-profile indicated a two-phase non-linear elimination and/or distribution of inhaled mAbX. Lung exposition was higher than the systemic one over a period of 33 hours and above MabX affinity for its target. The microdialysis results were supported by an excellent relationship with dosages from lung extracts.     

Therapeutic potential of plant-derived tannins in non-malignant respiratory diseases

Respiratory diseases are the major cause of human illness and death around the world. Despite advances in detection and treatment, very few classes of safe and effective therapy have been introduced to date. At present, phytochemicals are getting more attention because of their diverse beneficial activities and minimal toxicity. Tannins are polyphenolic secondary metabolites with high molecular weights, which are naturally present in a wide variety of fruits, vegetables, cereals, and leguminous seeds. Many tannins are endowed with well-recognized protective properties, such as anti-cancer, anti-microbial, anti-oxidant, anti-hyperglycemic, and many others. This review summarizes a large body of experimental evidence implicating that tannins are helpful in tackling a wide range of non-malignant respiratory diseases including acute lung injury (ALI), pulmonary fibrosis, asthma, pulmonary hypertension, and chronic obstructive pulmonary disease (COPD). Mechanistic pathways by which various classes of tannins execute their beneficial effects are discussed. In addition, clinical trials and our perspective on future research with tannins are also reviewed.     

Microbiota: A Missing Link in The Pathogenesis of Chronic Lung Inflammatory Diseases

Chronic respiratory diseases account for high morbidity and mortality, with asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) being the most prevalent globally. Even though the diseases increase in prevalence, the exact underlying mechanisms have still not been fully understood. Despite their differences in nature, pathophysiologies, and clinical phenotypes, a growing body of evidence indicates that the presence of lung microbiota can shape the pathogenic processes underlying chronic inflammation, typically observed in the course of the diseases. Therefore, the characterization of the lung microbiota may shed new light on the pathogenesis of these diseases. Specifically, in chronic respiratory tract diseases, the human microbiota may contribute to the disease’s development and severity. The present review explores the role of the microbiota in the area of chronic pulmonary diseases, especially COPD, asthma, and CF.     

Current status and prospects of basic research and clinical application of mesenchymal stem cells in acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a common and clinically devastating disease that causes respiratory failure. Morbidity and mortality of patients in intensive care units are stubbornly high, and various complications severely affect the quality of life of survivors. The pathophysiology of ARDS includes increased alveolar–capillary membrane permeability, an influx of protein-rich pulmonary edema fluid, and surfactant dysfunction leading to severe hypoxemia. At present, the main treatment for ARDS is mechanical treatment combined with diuretics to reduce pulmonary edema, which primarily improves symptoms, but the prognosis of patients with ARDS is still very poor. Mesenchymal stem cells (MSCs) are stromal cells that possess the capacity to self-renew and also exhibit multilineage differentiation. MSCs can be isolated from a variety of tissues, such as the umbilical cord, endometrial polyps, menstrual blood, bone marrow, and adipose tissues. Studies have confirmed the critical healing and immunomodulatory properties of MSCs in the treatment of a variety of diseases. Recently, the potential of stem cells in treating ARDS has been explored via basic research and clinical trials. The efficacy of MSCs has been shown in a variety of in vivo models of ARDS, reducing bacterial pneumonia and ischemia-reperfusion injury while promoting the repair of ventilator-induced lung injury. This article reviews the current basic research findings and clinical applications of MSCs in the treatment of ARDS in order to emphasize the clinical prospects of MSCs.     

肺部菌群和肠道菌群在两种常见肺疾病中 作用的研究进展

哮喘、慢性阻塞性肺疾病(COPD)是常见高发的肺部疾病,相关发病机制尚待阐明。近年来,菌群对哮喘、COPD的发生发展的作用越来越引起重视。本文梳理了近期肺部菌群和肠道菌群在哮喘、COPD中的作用及机制相关文献,分别从肺部菌群和肠道菌群的角度,分析它们对哮喘、COPD的作用机制以及肺部菌群和肠道菌群之间相互调控的联系,以期进一步深入了解菌群在常见肺部疾病中的意义,为寻找更有效的防治哮喘、COPD的作用靶点或者分子提供相关可借鉴的思路。