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长期以来,嵌合抗原受体T细胞(antigen receptor t-cell immunotherapy,CAR-T)疗法虽在血液肿瘤治疗中屡创奇迹,但其高昂的成本与复杂的体外制造工艺却如同“达摩克利斯之剑”。传统的CAR-T需要将患者的T细胞提取出体外,在实验室进行数周的基因改造与扩增后再回输。这不仅导致每剂疗法售价高达数十万美元,长达3~6周的等待周期也让许多急重症患者失去了生存机会。

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(图片来源:杜克大学官网)

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    长期以来,嵌合抗原受体T细胞(antigen receptor t-cell immunotherapy,CAR-T)疗法虽在血液肿瘤治疗中屡创奇迹,但其高昂的成本与复杂的体外制造工艺却如同“达摩克利斯之剑”。传统的CAR-T需要将患者的T细胞提取出体外,在实验室进行数周的基因改造与扩增后再回输。这不仅导致每剂疗法售价高达数十万美元,长达3~6周的等待周期也让许多急重症患者失去了生存机会。

    . 原位细胞疗法像打疫苗一样治疗癌症. 科技导报, 2026 , 44 (6) : 9 -9 .
    . Science & Technology Review, 2026 , 44 (6) : 9 -9 .
    长期以来,嵌合抗原受体T细胞(antigen receptor t-cell immunotherapy,CAR-T)疗法虽在血液肿瘤治疗中屡创奇迹,但其高昂的成本与复杂的体外制造工艺却如同“达摩克利斯之剑”。传统的CAR-T需要将患者的T细胞提取出体外,在实验室进行数周的基因改造与扩增后再回输。这不仅导致每剂疗法售价高达数十万美元,长达3~6周的等待周期也让许多急重症患者失去了生存机会。
    由加州大学与格拉德斯通研究所(Gladstone Institutes)的Justin Eyquem、Jennifer Doudna等人领衔的团队,成功开发出一种创新的“双载体系统”。该系统结合了工程化包膜递送载体(enveloped delivery vehicle,EDV)与定向进化的腺相关病毒(adeno-associated virus human T-cell targeted variant 7,AAV-hT7),首次实现了在生物体内直接对T细胞进行原位、位点特异性的大片段DNA整合。这一技术突破意味着,癌症治疗有望从昂贵的“定制服务”转变为像注射疫苗一样便捷的“现成”给药,正式开启了细胞治疗的“体内制造”元年。2026年3月18日,相关研究成果发表于《Nature》。
    该研究的核心精妙之处在于将基因编辑的“手术刀”与“修复模板”分别装载。EDV负责运送预先组装好的蛋白复合体,其表面修饰的特异性抗体如同精准的全球定位系统(global positioning system,GPS),确保载荷仅进入T细胞并提供初始激活信号。与此同时,进化版的AAV-hT7则克服了人类血清的拦截,高效地将CAR基因模板送达靶点。这种双管齐下的策略,在复杂的血液环境中实现了纳米级的精确手术,成功将CAR基因精确插入到T细胞受体的关键位点。
    与传统方法不同,这项新技术选择在体内利用内源性启动子驱动CAR的表达。这种“生理化”的调节方式模拟了天然免疫反应,避免了传统CAR-T因信号持续开启而导致的细胞过早“衰竭”。实验数据显示,在体内原位生成的CAR-T细胞由于从未离开过自然的生理微环境,保留了更强的生命力与杀伤力。这种“原生态”的免疫战士即便在较低剂量下,也能展现出比实验室制造产品更强大的肿瘤监视与清除能力。
    在针对急性白血病和多发性骨髓瘤的小鼠模型中,单次注射该双载体系统便能在2周内彻底清除癌细胞。更令人振奋的是,该技术在一直被视为CAR-T“禁区”的实体瘤领域也取得了重大进展。研究证明,体内生成的靶向T细胞能够成功穿透物理屏障,消除恶性肉瘤。这一成果为占癌症总数85%的实体瘤治疗点燃了全新的希望,也证明了体内重编程技术在应对复杂肿瘤环境时的巨大潜力。
    这一技术的潜在影响已不限于肿瘤治疗。已有研究和综述显示,CAR-T平台正被拓展至自身免疫病中的“免疫重置”、基于工程化调节性T细胞的免疫耐受重建,以及面向衰老细胞清除和慢性炎症控制的非肿瘤应用。
    (来源:《Nature》)

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    鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
    小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
    多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
    红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
    小菇属 Mycena 11 5.26
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    栓菌属 Trametes 5 2.39
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