基因修饰细胞介导的肿瘤治疗

肿瘤的基因治疗,最终都是通过基因修饰细胞介导完成的,这些基因修饰细胞可分为（1）免疫基因修饰的肿瘤细胞疫苗;（2）自杀基因或抑癌基因修饰的细胞疫苗;（3）基因修饰的树突状细胞（DC）疫苗;（4）基因修饰造血干细胞;（5）基因修饰淋巴细胞;（6）基因修饰血管内皮细胞及其它。它们在肿瘤的基因治疗中各有特点,本主要介绍这些方面的研究进展。     

肿瘤抗原基因转染的DC疫苗研究进展

树突状细胞是机体内最重要、功能最强的专职抗原递呈细胞,是抗肿瘤免疫的最好佐剂。将不同形式肿瘤抗原负载的DC制成疫苗,可以在体内诱导特异性杀伤性T细胞（CTL）的生成,激发人体有效的特异性抗肿瘤免疫功能。其中肿瘤抗原原因转当的DC疫苗具有很多独特的优点,可望作为一种新型肿瘤疫苗用于肿瘤的防治。本文主要就其作用特点、体内应用的可行性及抗肿瘤作用效果的实验研究进展等方面作一综述。     

抗黑色素瘤及结肠直肠癌的治疗性疫苗

作的总体策略是开发多价重组疫苗,这种疫苗能够在黑色素瘤或结肠直肠癌病人中激发产生广泛的免疫应答,作在中报告了初步研究的结果,将携带细胞因子基因的重组金丝雀痘病毒进行肿瘤内投递至病人之后,以期评价这种重组疫苗的作用。近来的研究主要集中在采用独特的衍生于称之为ALVAC的金丝雀痘病毒的载体系统,利用初免—加强免疫程序,观察肿瘤特异性T细胞应答。在ALVAC中,作掺入编码肿瘤相关抗原(TAAs)的基因。在评价ALVAC　CEA从候选疫苗的结肠癌临床研究中已经证实这种方案是安全的,并且能够诱导肿瘤特异性T细胞应答。     

肿瘤预防性疫苗的研究进展

肿瘤疫苗包括肿瘤治疗性疫苗和肿瘤预防性疫苗。流行病学调查显示,人群罹患传染病或接种疫苗可降低发生肿瘤的风险,为肿瘤的预防和控制提出了新思路。近年来,肿瘤预防性疫苗尤其是抗致癌病原体预防性疫苗的研究已取得突破性进展,如乙型肝炎疫苗已证实对原发性肝癌具有预防作用,预防宫颈癌的人乳头瘤病毒疫苗已上市并广泛应用,预防胃癌的幽门螺杆菌疫苗研究也已进入临床研究。其次,以肿瘤抗原作为有效成分也是制备肿瘤预防性疫苗的一种新思路。简述了病原体感染及疫苗接种对发生肿瘤危险性的影响,并对肿瘤预防性疫苗的研究进展进行了总结和概述。     

免疫佐剂在肿瘤免疫疗法中的应用进展 *

免疫疗法是预防和治疗疾病的有效手段之一.近年来,肿瘤免疫疗法已成为一种新型治疗方法,相关肿瘤疫苗已在多种肿瘤的治疗中被证明有效.然而,在肿瘤疫苗的设计中,肿瘤抗原免疫原性弱,应答率低等问题是目前面对的一大挑战,佐剂的加入为问题的解决提供了一种新的方法和思路.免疫佐剂在提高肿瘤抗原免疫原性,激活机体适应性免疫应答等方面起着十分重要的作用.为了解近几年免疫佐剂的发展及其研究现状,针对目前常用的抗肿瘤佐剂进行综述,并总结了其对免疫系统的作用机制,为后续的疫苗设计策略提供帮助.     

树突状细胞与肿瘤免疫系统相互作用研究进展

树突状细胞(dendritic cells, DCs)是功能最强的专职抗原呈递细胞。DCs能够摄取和呈递抗原表达共刺激分子,并迁移到淋巴器官激活T细胞,进而启动免疫反应。在肿瘤发展过程中,DCs不仅能诱导抗肿瘤免疫反应,还可以诱导免疫耐受。现对树突状细胞的生物学特性、树突状细胞与肿瘤免疫系统的相互作用等方面的最新研究进展进行综述,并介绍免疫治疗中基于树突状细胞疫苗的多种治疗方法。相关研究对于更好地理解肿瘤微环境中树突状细胞在肿瘤演化中的作用、寻找新的治疗策略以及改进治疗方法至关重要。     

转基因人肺腺癌细胞株的建立

以逆转录病毒ｐＬＸＳＬ为载体与人细胞介素２基因（ＩＬ－２）重组,用电穿孔技术将其重组子ｐＬＩＬ—２ＳＮ导入ＰＡ３１７细胞中,建立了逆转染病毒包装体系细胞ＰＡ３１７／ｐＬＩＬ—２ＳＮ。应用逆转录病毒包装体系细胞上清液去转染入肺腺癌细胞ＳＰＣ—Ａ１,经过２０天含Ｇ４１８培液的筛选式培养,历经了５０代的传代培养,获得了转白细胞介素２基因的人肺腺癌细胞株ＳＰＣ－Ａ１／ＩＬ－２。该细胞（ＳＰＣ－Ａ１／ＩＬ－２）经ＰＣＲ技术验证外源性目的基因（ＩＬ－２ｇｅｎｅ）导入细胞内,且证明该细胞能表达ＩＬ—２基因（有ＩＬ－２的分泌）。我们研究的目的是对肿瘤细胞的特异性抗原修饰、对肿瘤细胞进行处理。试图建立肿瘤疫苗。     

EGFR基因重组T7噬菌体疫苗抗Lewis肺癌的实验研究

本研究中制备了表达表皮生长因子受体（EGFR）部分肽段的基因重组T7噬菌体疫苗,并开展了诱导小鼠产生内源性抗EGFR抗体的实验性抗肿瘤作用研究。由T7噬菌体展示系统将7个经筛选的异种属（人源、鸡源）EGFR膜外区片段展示在其壳体次要头蛋白（P10B）上,用所制备的基因重组噬菌体疫苗免疫小鼠,免疫4W后皮下接种Lewis肺癌细胞,10d后分离瘤体并称重,观察各实验组的抗肿瘤效果。WesternBlot检测重组的融合壳蛋白均有EGFR抗原性：高表达EGFR的A431细胞与免疫3W的小鼠抗血清结合并被荧光二抗标记．流式细胞仪检测法确认有抗EGFR抗体产生;各实验组肿瘤均重统计结果显示,P—CL1—670组、P—cp1-130组、P—cp2—136组、P—cp3—145组、P—cp4—142组与空白噬菌体组差异性显著。说明表达EGFR的基因重组噬菌体疫苗诱导产生的内源性抗体,在一定程度上抑制了EGFR阳性肿瘤的生长,为诱导型内源性抗EGFR抗体的肿瘤靶向治疗研究开辟了新的途径。     

癌症疫苗

癌症疫苗已在动物以及人体进行了广泛的试验。第一代癌症疫苗是用自身的或同种异体的肿瘤制成的全细胞制剂或溶胞产物制剂。用这些候选疫苗进行的临床研究在于确定通过免疫癌症病人来治疗癌症的可行性。在这样的一些试验中,无论从长期存活率还是复发率方面均看到了明显的好处。最近设计并已用于人体试验的是第二代癌症疫苗,它们是用性质确定的肿瘤相关抗原,即是由癌细胞而非正常细胞主要表达的或经选择的分子制备的疫苗。目前得到的结果证明,它们是安全的,而且能够激发肿瘤抗原特异性的体液和细胞免疫应答,没有诱发自身免疫这一临床难题。肿瘤生物学和肿瘤免疫学的进展对更好地了解一些肿瘤逃逸宿主免疫作用的机理很有帮助。这些新的知识将被用于设计将来的癌症疫苗,它们很可能会以多种肿瘤相关抗原为目标并结合有合成佐剂和(或)免疫刺激剂—细胞因子。最后,为了确定接种试验疫苗患的免疫应答与临床之间的相关性,特别需要一种专门的工具以对免疫应答进行定性和定量评价。     

增强DNA疫苗免疫应答的新进展

DNA疫苗为编码抗原蛋白的真核表达载体,注入体内后在原位表达所编码的抗原并诱导免疫应答,在预防感染、治疗自身免疫性疾病、过敏性疾病和肿瘤等疫病中有着很好的应用前景。但与灭活疫苗相比,其免疫效价还比较低。有多种策略能够增强或调节DNA疫苗诱导的免疫应答,其中,作为外源基因载体的质粒的组成及插入的有关基因均可直接或间接地影响免疫反应的效果,在构建DNA疫苗质粒时,加入细胞因子、融合信号、泛素等基因以及ISS序列,另外还可以通过设计一些对抗原提成细胞有影响的分子共注射,以及加入转移分子,都可以明显增强DNA疫苗的免疫效果,从而有利于研制更有效的DNA疫苗。     

DNA fusion vaccines against B-cell tumors

DNA vaccination is currently being explored as a potential strategy for combatting cancer. However, tumor antigens are often weak and the immune system of patients may be compromised. For B-cell tumors, immunoglobulin idiotypic antigens provide defined targets but are poorly immunogenic. Fusion of a sequence derived from tetanus toxin to the genes encoding idiotypic determinants has proved highly effective in activating protective anti-tumor immunity. DNA fusion vaccines containing immuno-enhancing sequences can augment and direct immune attack on a range of target antigens. Gene-based fusion vaccines offer ease of manipulation and flexible design to activate effective attack on cancer.     

Her-2 DNA versus cell vaccine: immunogenicity and anti-tumor activity

Direct comparison and ranking of vaccine formulations in pre-clinical studies will expedite the identification of cancer vaccines for clinical trials. Two human ErbB-2 (Her-2) vaccines, naked DNA and whole cell vaccine, were tested side-by-side in wild type and Her-2 transgenic mice. Both vaccines can induce humoral and cellular immunity to the entire repertoire of Her-2 epitopes. Mice were electro-vaccinated i.m. with a mixture of pGM-CSF and pE2TM, the latter encodes Her-2 extracellular and transmembrane domains. Alternatively, mice were injected i.p. with human ovarian cancer SKOV3 cells that have amplified Her-2. In wild type mice, comparable levels of Her-2 antibodies (Ab) were induced by these two vaccines. However, T cell immunity and protection against Her-2⁺ tumors were superior in DNA vaccinated mice. In BALB Her-2 transgenic (Tg) mice, which were tolerant to Her-2, DNA and cell vaccines were administered after regulatory T cells (Treg) were removed by anti-CD25 mAb. Again, comparable levels of Her-2 Ab were induced, but DNA vaccines rendered greater anti-tumor activity. In B6xDR3 Her-2 Tg mice that expressed the autoimmune prone HLA-DR3 allele, higher levels of Her-2 Ab were induced by SKOV3 cell than by Her-2 DNA. But anti-tumor activity was still more profound in DNA vaccinated mice. Therefore, Her-2 DNA vaccine induced greater anti-tumor immunity than cell vaccine, whether mice were tolerant to Her-2 or susceptible to autoimmunity. Through such side-by-side comparisons in appropriate pre-clinical test systems, the more effective vaccine formulations will emerge as candidates for clinical trials. P. J. Whittington, O. Radkevich-Brown and J. B. Jacob have contributed equally to this work.     

佐剂增强的肿瘤细胞裂解物疫苗抗小鼠H22肝癌作用

以鼠源肝癌H22全细胞裂解物为抗原,通过化学偶联白喉毒素(DT)和串联重复的T辅助表位mH-SP70407-426肽段,混合OK432(链球菌A群)制成肿瘤全细胞疫苗H22-DT-M2-OK432(HDTMOK)。治疗性免疫结果显示,疫苗激发的免疫应答对H22肿瘤起到了有效的抑制作用。为进一步提高该疫苗的抗肿瘤效果,用偶联的疫苗制备免疫刺激复合物(ISCOM),并验证其抑瘤效果。治疗性免疫结果显示,与PBS组相比,ISCOM疫苗组平均瘤重和瘤体积显著降低(P<0.01),同时有效地抑制了小鼠皮内肿瘤模型中的血管新生(P<0.01);ELISA法从血清中检测到高滴度的抗体。且与HDTMOK疫苗相比,ISCOM疫苗抑瘤作用提升显著(P<0.05)。HDTMOK能有效抑制小鼠肝癌实体瘤生长,佐剂配伍后的疫苗对H22的抑制更为显著,能够有效提升肿瘤全细胞疫苗的抗肿瘤能力。     

体外大量制备新型gp96肿瘤疫苗及其诱导的特异性抗肿瘤免疫应答分析

旨在体外组装酵母菌表达的gp96 (Recombinant gp96,rgp96) 蛋白与B16.F10黑色素瘤抗原,大量制备新型gp96肿瘤疫苗,并研究其诱导的特异性抗肿瘤免疫应答。利用体外组装的rgp96-肿瘤抗原复合物免疫C57BL/6小鼠,并通过酶联免疫斑点实验、细胞因子染色、杀伤实验技术进行分析,结果显示与单纯rgp96或肿瘤抗原免疫组相比,体外组装的rgp96-肿瘤抗原复合物免疫能够显著抑制B16肿瘤的生长,而且能够明显提高肿瘤特异性T细胞活性。rgp96-肿瘤抗原复合物的抗肿瘤免疫活性与从肿瘤组织中提取的gp96接近。研究结果为大量制备新型gp96肿瘤疫苗提供了依据。     

DNA fusion vaccines enter the clinic

Induction of effective immune attack on cancer cells in patients requires conversion of weak tumor antigens into strong immunogens. Our strategy employs genetic technology to create DNA vaccines containing tumor antigen sequences fused to microbial genes. The fused microbial protein engages local CD4+ T cells to provide help for anti-tumor immunity, and to reverse potential regulation. In this review, we focus on induction of CD8+ T cells able to kill target tumor cells. The DNA vaccines incorporate tumor-derived peptide sequences fused to an engineered domain of tetanus toxin. In multiple models, this design induces strong CD8+ T-cell responses, able to suppress tumor growth. For clinical relevance, we have used “humanized” mice expressing HLA-A2, successfully inducing cytolytic T-cell responses against a range of candidate human peptides. To overcome physical restriction in translating to patients, we have used electroporation. Clinical trials of patients with cancer are showing induction of responses, with preliminary indications of suppression of tumor growth and evidence for clinically manageable concomitant autoimmunity.     

Curative potential of GM-CSF-secreting tumor cell vaccines on established orthotopic liver tumors: Mechanisms for the superior antitumor activity of live tumor cell vaccines

In preclinical studies, tumor cells genetically engineered to secrete cytokines, hereafter referred to as tumor cell vaccines, can often generate systemic antitumor immunity. This study investigated the therapeutic effects of live or irradiated tumor cell vaccines that secrete granulocyte-macrophage colony-stimulating factor (GM-CSF) on established orthotopic liver tumors. Experimental results indicated that two doses (3 × 10⁷ cells per dose) of irradiated tumor cell vaccines were therapeutically ineffective, whereas one dose (3 × 10⁶ cells) of live tumor cell vaccines caused complete tumor regression. In vivo depletion of CD8+ T cells, but not natural killer cells, restored tumor formation in the live vaccine-treated animals. Additionally, the treatment of cells with live vaccine induced markedly higher levels of cytotoxic T lymphocyte activity than the irradiated vaccines in the draining lymph nodes. The higher levels of cytokine and antigen loads could partly explain the superior antitumor activity of live tumor cell vaccines, but other unidentified mechanisms could also play a role in the early T cell activation in the lymph nodes. A protocol using multiple and higher dosages of irradiated tumor cell vaccines also caused significant regression of liver tumors. These results suggest that the GM-CSF-secreting tumor cell vaccines are highly promising for orthotopic liver tumors if higher levels of immune responses are elicited during early tumor development.     

肿瘤DNA疫苗佐剂研究进展

对近年来在增加肿瘤DNA疫苗免疫原性、提高肿瘤DNA疫苗效力方面所取得的进展予以综述。简要阐述了以下几种较有效的增强肿瘤DNA疫苗效力策略的机制和进展：（1）以细胞因子表达质粒为佐剂;（2）以质粒编码的趋化因子、协同刺激分子、共刺激分子、补体为佐剂;（3）以CPGODN为佐剂;（4）其他一些佐剂。     

Highly potent mRNA based cancer vaccines represent an attractive platform for combination therapies supporting an improved therapeutic effect

Direct vaccination with mRNA encoding tumor antigens is a novel and promising approach in cancer immunotherapy. CureVac's mRNA vaccines contain free and protamine-complexed mRNA. Such two-component mRNA vaccines support both antigen expression and immune stimulation. These self-adjuvanting RNA vaccines, administered intradermally without any additional adjuvant, induce a comprehensive balanced immune response, comprising antigen specific CD4+ T cells, CD8+ T cells and B cells. The balanced immune response results in a strong anti-tumor effect and complete protection against antigen positive tumor cells. This tumor inhibition elicited by mRNA vaccines is a result of the concerted action of different players. After just two intradermal vaccinations, we observe multiple changes at the tumor site, including the up-regulation of many genes connected to T and natural killer cell activation, as well as genes responsible for improved infiltration of immune cells into the tumor via chemotaxis. The two-component mRNA vaccines induce a very fast and boostable immune response. Therefore, the vaccination schedules can be adjusted to suit the clinical situation. Moreover, by combining the mRNA vaccines with therapies in clinical use (chemotherapy or anti-CTLA-4 antibody therapy), an even more effective anti-tumor response can be elicited. The first clinical data obtained from two separate Phase I/IIa trials conducted in PCA (prostate cancer) and NSCLC (non-small cell lung carcinoma) patients have shown that the two-component mRNA vaccines are safe, well tolerated and highly immunogenic in humans.     

Induction of antigen-specific tumor immunity by genetic and cellular vaccines against MAGE: enhanced tumor protection by coexpression of granulocyte-macrophage colony-stimulating factor and B7-1.

BACKGROUND: A number of tumors express antigens that are recognized by specific cytotoxic T cells. The normal host immune responses, however, are not usually sufficient to cause tumor rejection. Using appropriate immunization strategies, tumor-specific antigens may serve as targets against which tumor-destructive immune responses can be generated. MAGE-1 and MAGE-3 are two clinically relevant antigens expressed in many human melanomas and other tumors, but not in normal tissues, except testis. Here, we have investigated whether DNA and cellular vaccines against MAGE-1 and MAGE-3 can induce antigen-specific anti-tumor immunity and cause rejection of MAGE-expressing tumors. MATERIALS AND METHODS: Mice were immunized against MAGE-1 and MAGE-3 by subcutaneous injection of genetically modified embryonic fibroblasts or intramuscular injection of purified DNA. Mice were injected with lethal doses of B16 melanoma cells expressing the corresponding MAGE antigens or the unrelated protein SIV tat, and tumor development and survival were monitored. RESULTS: Intramuscular expression of MAGE-1 and MAGE-3 by plasmid DNA injection and subcutaneous immunization with syngeneic mouse embryonic fibroblasts transduced with recombinant retroviruses to express these antigens induced specific immunity against tumors expressing MAGE-1 and MAGE-3. Both CD4+ and CD8+ T cells were required for anti-tumor immunity. Coexpression of granulocyte-macrophage colony-stimulating factor (GM-CSF) or B7-1 significantly increased anti-tumor immunity in an antigen-specific manner and resulted in a considerable proportion of mice surviving lethal tumor challenge. CONCLUSIONS: Our results suggest that genetic and cellular vaccines against MAGE and other tumor antigens may be useful for the therapy of tumors expressing specific markers, and that GM-CSF and B7-1 are potent stimulators for the induction of antigen-specific tumor immunity.