Article(id=1212693338583646823, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1212693337426018913, articleNumber=1001-2494(2024)20-1899-11, orderNo=null, doi=10.11669/cpj.2024.20.003, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1719504000000, receivedDateStr=2024-06-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1767058222671, onlineDateStr=2025-12-30, pubDate=1729526400000, pubDateStr=2024-10-22, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1767058222671, onlineIssueDateStr=2025-12-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1767058222671, creator=13701087609, updateTime=1767058222671, updator=13701087609, issue=Issue{id=1212693337426018913, tenantId=1146029695717560320, journalId=1190317699101192196, year='2024', volume='59', issue='20', pageStart='1881', pageEnd='1984', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1767058222394, creator=13701087609, updateTime=1767059439376, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1212698441885602499, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1212693337426018913, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1212698441889796804, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1212693337426018913, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1899, endPage=1909, ext={EN=ArticleExt(id=1212693338805944938, articleId=1212693338583646823, tenantId=1146029695717560320, journalId=1190317699101192196, language=EN, title=Toxicity Study of Cytokine Induced Killer Cells in Immunodeficient NPG Mice, columnId=null, journalTitle=Chinese Pharmaceutical Journal, columnName=null, runingTitle=null, highlight=null, articleAbstract=

OBJECTVIE To provide safety basis for clinical application, and evaluate the toxicity CIK cells by repeated administration of CIK cells in severe immunodeficient NPG mouse model. METHODS The NPG mice were randomized into two groups: the main experimental group and the satellite group. Each group was divided into vehicle control group, low dose group (2×106 cells per mouse) and high dose group (3×107 cells per mouse). The CIK cells were given every two weeks for 6 times with 28-day recovery. During the experiment, the clinical symptoms, body weight and food intake were observed in the main experimental group. Blood samples were dissected and collected at the end of the administration period and recovery period, and the hematology, serum biochemical examination, cytokine detection, organ weighing and pathological examination were performed. The blood samples of satellite animals were collected to investigate the distribution of CIK cells before the first and last administration, 3 h, 1 d, 3 d, 10 d after the administration, and after the recovery period. RESULTS After repeated administration for 6 times at low dose, no obvious toxic reaction was observed in mice. A few CIK cells were detected in the blood at 1 day after the first dose and at some time points (3 h, day 10, day 29) after the last dose. High levels of CIK cells were detected in the blood of mice after repeated administration of 6 times at high dose. The levels of IFN-γ, TNF, IL-10, IL-2 and Il-10 in serum were increased. At the same time, significant graft-versus-host disease (GvHD) reaction was observed in mice, including the changes of clinical symptoms, body weight, food intake, hematology and serum biochemistry, mixed cell aggregation and GvHD-related lesions occurred in multiple organs of animals. CONCLUSION The data from the study indicates that no significant toxic reaction was observed at the dose of 2×106 cells per mouse (the clinical dosage). GvHD associated with xenotransplantation was observed at a dose of 3×107 cells per mouse, and no other related toxicity was observed. These data will facilitate CIK cells to enter into clinical trials.

, correspAuthors=Xu LU, Xingchao GENG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Ying HUANG, Jingwei LIU, Tiantian HOU, Hairuo WEN, Chao QIN, Xu LU, Xingchao GENG), CN=ArticleExt(id=1212693341238641369, articleId=1212693338583646823, tenantId=1146029695717560320, journalId=1190317699101192196, language=CN, title=CIK细胞在免疫缺陷NPG小鼠体内重复给药毒性研究, columnId=1212693338294239845, journalTitle=中国药学杂志, columnName=细胞治疗产品评价专栏, runingTitle=null, highlight=null, articleAbstract=

目的 采用重度免疫缺陷NPG小鼠模型对细胞因子诱导的杀伤性(CIK)细胞治疗产品进行毒性研究,考察多次给药后的毒性反应,为临床应用提供安全性依据。方法 采用NPG小鼠,设主实验组和卫星组两个大组,每大组分为溶媒对照组、低剂量组(每只小鼠给予2×106个细胞)和高剂量组(每只小鼠给予3×107个细胞)。每两周给药1次,共给药6次,恢复期28 d。实验期间,主实验组动物进行临床症状观察、体质量和摄食量测定,并于给药期结束和恢复期结束后解剖采血,进行血液学和血清生化检查、细胞因子检测、脏器称重和病理学检查。卫星组动物于首次给药和末次给药前、给药后3 h、1、3、10 d以及恢复期结束后采血,进行细胞表型分析,以考察CIK细胞的分布情况。结果 在低剂量组重复给药6次,小鼠未见明显毒性反应,仅个别动物出现弓背、摄食量下降和葡萄糖(GLU)、总胆固醇(CHO)升高等症状,血液中仅在首次给药后1 d和末次给药后个别时间点(3 h、10 d、29 d)检测到少量CIK细胞。高剂量组重复给药6次,小鼠血液中可检测较高水平的CIK细胞,血清中γ-干扰素(IFN-γ)、肿瘤坏死因子(TNF)、白细胞介素10(IL-10),白细胞介素2(IL-2)等具有肿瘤杀伤作用的细胞因子升高,同时小鼠出现明显的移植物抗宿主反应(graft-versus-host disease,GvHD),表现为动物临床症状、体质量、摄食量、血液学和血清生化等多个指标的变化、动物多脏器发生混合细胞聚集和GvHD相关的病变。结论 NPG小鼠重复给予CIK细胞,在每只小鼠给予2×106个细胞的剂量(临床拟用剂量)下动物未见显著的毒性反应;在每只小鼠给予3×107个细胞剂量下动物出现与异种细胞移植相关的GvHD反应,未见其他相关的毒理学反应。该结果为CIK细胞进入临床试验奠定了基础。

, correspAuthors=卢戌, 耿兴超, authorNote=null, correspAuthorsNote=
* 卢戌,男,博士,正高级工程师 研究方向:生物医药开发研究 Tel:(010)80498890;
耿兴超,男,博士,研究员 研究方向:药物毒理研究 Tel:(010)62876255
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黄瑛,女,博士,副研究员 研究方向:药物毒理研究

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Trends Immunol, 2018, 39(9):748-763., articleTitle=Humanized mice for the study of immuno-oncology, refAbstract=null)], funds=[Fund(id=1212799324547895489, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, awardId=2021YFA1101602, language=CN, fundingSource=国家重点研发计划课题资助(2021YFA1101602), fundOrder=null, country=null), Fund(id=1212799324635975875, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, awardId=GJJS-2022-6-1, language=CN, fundingSource=中国食品药品检定研究院关键技术研究基金资助(GJJS-2022-6-1), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1212799316327060452, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, xref=1, ext=[AuthorCompanyExt(id=1212799316335449060, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, companyId=1212799316327060452, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 The Beijing Key Lab for Pre-clinical Safety Evaluation of Drugs, National Center for Safety Evaluation of Drugs, National Institutes for Food and Drug Control, Beijing 100176, China), AuthorCompanyExt(id=1212799316343837670, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, companyId=1212799316327060452, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1 中国食品药品检定研究院, 国家药物安全评价监测中心,药物非临床安全评价研究北京市重点实验室, 北京 100176)]), AuthorCompany(id=1212799316431918059, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, xref=2, ext=[AuthorCompanyExt(id=1212799316444500969, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, companyId=1212799316431918059, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 Karh Biohealthcare Biotechnology (Zhejiang) Co., Ltd., Jiaxing 314100, China), AuthorCompanyExt(id=1212799316452889578, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, companyId=1212799316431918059, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2 康爱瑞浩生物医药(浙江)股份有限公司, 浙江 嘉兴 314100)])], figs=[ArticleFig(id=1212799320844324966, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.1, caption=Animal grouping, dose setting and toxicological detection index setting of severe immunodeficient NPG mice, figureFileSmall=E7eQrgiMDXnvMGiyAp3/xg==, figureFileBig=naKAZJ1UNFyKo2i+qm4KCg==, tableContent=null), ArticleFig(id=1212799320924016746, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图1, caption=重度免疫缺陷NPG小鼠给药组别以及毒理学检测指标设置, figureFileSmall=E7eQrgiMDXnvMGiyAp3/xg==, figureFileBig=naKAZJ1UNFyKo2i+qm4KCg==, tableContent=null), ArticleFig(id=1212799321016291437, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.2, caption=The clinical symptoms of NPG mice after administration of CIK cells, figureFileSmall=JYiqTMDzZtDXK3Th3JDloA==, figureFileBig=LPNlZdf7tTbNhjmWybjZZA==, tableContent=null), ArticleFig(id=1212799321087594609, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图2, caption=细胞因子诱导的杀伤性(CIK)细胞给药后NPG小鼠临床症状观察结果, figureFileSmall=JYiqTMDzZtDXK3Th3JDloA==, figureFileBig=LPNlZdf7tTbNhjmWybjZZA==, tableContent=null), ArticleFig(id=1212799321163092084, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.3, caption=Changes of body weight after repeated administration of CIK cells

A-weight of male animals in dosing period; B-weight of female animals in dosing period;C-weight of male animals in recovery period;D-weight of female animals in recovery period; 1)P<0.05,2)P<0.01, compared with the vehicle control group.

, figureFileSmall=/yS/rQ49JlgMV9a4tbAiFA==, figureFileBig=Kh7DvWmUUEuNLGnlrU2J+A==, tableContent=null), ArticleFig(id=1212799321293115513, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图3, caption=CIK细胞重复给药后NPG小鼠体质量变化

A-给药期雄性动物体质量;B-给药期雌性动物体质量;C-恢复期雄性动物体质量;D-恢复期雌性体质量;与溶媒对照组相比,1)P<0.05,2)P<0.01。

, figureFileSmall=/yS/rQ49JlgMV9a4tbAiFA==, figureFileBig=Kh7DvWmUUEuNLGnlrU2J+A==, tableContent=null), ArticleFig(id=1212799321444110459, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.4, caption=Changes of food intake after repeated administration of CIK cells. n=12,$\stackrel{-}{x}$±s

A-food intake of male animals in dosing period; B-food intake of female animals in dosing period;C-food intake of male animals in recovery period;D-food intake of female animals in recovery period; 1)P<0.05, compared with the vehicle control group.

, figureFileSmall=H4+gqD27X0CCcOUMmLYYGA==, figureFileBig=hsYLX0Yc39yRq0m7bueALA==, tableContent=null), ArticleFig(id=1212799321658019967, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图4, caption=CIK细胞重复给药后动物摄食量变化。n=12,$\stackrel{-}{x}$±s

A-给药期雄性动物摄食量;B-给药期雌性动物摄食量;C-恢复期雄性动物摄食量;D-恢复期雌性动物摄食量;与溶媒对照组相比,1)P<0.05。

, figureFileSmall=H4+gqD27X0CCcOUMmLYYGA==, figureFileBig=hsYLX0Yc39yRq0m7bueALA==, tableContent=null), ArticleFig(id=1212799321733517442, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.5, caption=The change of CD3+CD4+、CD3+CD8+ peripheral blood cells in NPG mice at different time points before and after the first administration. n=5,$\stackrel{-}{x}$±s, figureFileSmall=2phJ/4stiC4N1YNtgqUHsQ==, figureFileBig=O1pYlov4xooLxHUwr61LWQ==, tableContent=null), ArticleFig(id=1212799321809014918, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图5, caption=首次给药前后不同时间点NPG小鼠外周血液CD3+CD4+、CD3+CD8+细胞数量变化趋势图。n=5,$\stackrel{-}{x}$±s, figureFileSmall=2phJ/4stiC4N1YNtgqUHsQ==, figureFileBig=O1pYlov4xooLxHUwr61LWQ==, tableContent=null), ArticleFig(id=1212799321947426955, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.6, caption=The change of CD3+CD4+、CD3+CD8+ peripheral blood cells in NPG mice at different time points before and after the last administration. n=5,$\stackrel{-}{x}$±s, figureFileSmall=bQvVZ8weGXmTQlvBBtxMYA==, figureFileBig=Dq3vZo+jZ1R8JCnXiY+qSw==, tableContent=null), ArticleFig(id=1212799322022924430, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图6, caption=末次给药前/后不同时间点NPG小鼠外周血液CD3+CD4+、CD3+CD8+细胞数量变化趋势图。n=5,$\stackrel{-}{x}$±s, figureFileSmall=bQvVZ8weGXmTQlvBBtxMYA==, figureFileBig=Dq3vZo+jZ1R8JCnXiY+qSw==, tableContent=null), ArticleFig(id=1212799322115199122, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.7, caption=Detection of human cytokines in serum of NPG mice at different time points after CIK cells administration. n=10,$\stackrel{-}{x}$±s

A-30 d after the first administration; B-1 d after the last administration;C-end of recovery period; IFN-γ-interferon-γ;TNF-tumor necrosis factor;IL-10-interleukin-10;IL-6-interleukin-6;IL-4-interleukin-4;IL-2-interleukin-2; 1)P<0.05,2)P<0.01, compared with the vehicle control group.

, figureFileSmall=Go6v6ogBNtYjOiZsCO9uUw==, figureFileBig=pNI3L2UdV/ijWlSIoRH9pQ==, tableContent=null), ArticleFig(id=1212799322228445334, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图7, caption=CIK细胞给药后不同时间点NPG小鼠血清中人源细胞因子检测结果。n=10,$\stackrel{-}{x}$±s

A-首次给药后30 d;B-末次给药后1 d;C-恢复期结束;IFN-γ-干扰素-γ;TNF-肿瘤坏死因子;IL-10-白介素-10;IL-6-白介素-6;IL-4-白介素-4;IL-2-白介素-2;与溶媒对照组相比,1)P<0.05,2)P<0.01。

, figureFileSmall=Go6v6ogBNtYjOiZsCO9uUw==, figureFileBig=pNI3L2UdV/ijWlSIoRH9pQ==, tableContent=null), ArticleFig(id=1212799322320720027, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.8, caption=The results of determination of mouse-derived cytokines in serum of NPG mice at different time points after administration of CIK cells. n=10,$\stackrel{-}{x}$±s

A-30 d after the first administration; B-1 d after the last administration; C-end of recovery period; IFN-γ-interferon-γ;TNF-tumor necrosis factor;IL-10-interleukin-10;IL-6-interleukin-6;IL-4-interleukin-4;IL-2-interleukin-2; IL-17A-interleukin-17A; IFN-6-interferon-6; IFN-4-interferon-4; IFN-2-interferon-2;1)P<0.01, compared with the vehicle control group.

, figureFileSmall=OlZS7Ft5afMe5vudI4I2SQ==, figureFileBig=cIdZe/G9bofs0GdkfU9YJg==, tableContent=null), ArticleFig(id=1212799322425577630, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图8, caption=CIK细胞给药后不同时间点NPG小鼠血清中鼠源细胞因子检测结果。n=10,$\stackrel{-}{x}$±s

A-首次给药后30 d;B-末次给药后1 d;C-恢复期结束;IL-17A-白介素-17A;IFN-6-干扰素-6;IFN-4-干扰素-4;IFN-2-干扰素-2;与溶媒对照组相比,1)P<0.01。

, figureFileSmall=OlZS7Ft5afMe5vudI4I2SQ==, figureFileBig=cIdZe/G9bofs0GdkfU9YJg==, tableContent=null), ArticleFig(id=1212799322526240930, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.9, caption=Histopathological changes induced by CIK cell injection

A-lung in vehicle control group; B-lung in high dose group, severe mixed cell aggregation; C-thyroid in vehicle control group; D-thyroid in high dose group, moderate mixed cell aggregation; E-kidney in vehicle control group; F-kidney in high dose group, minimal mixed cell aggregation; G-spleen in vehicle control group; H-spleen in high dose group, mild mixed cell aggregation.

, figureFileSmall=+jEB/WEOmRzO9fc+O1u+Vw==, figureFileBig=MhMYdVv/wBo7qcIarKRKwA==, tableContent=null), ArticleFig(id=1212799322622709924, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图9, caption=CIK细胞注射后引发的组织病理改变

A-溶媒对照组肺脏;B-高剂量组肺脏,重度混合细胞聚集 ;C-溶媒对照组甲状腺;D-高剂量组甲状腺,中度混合细胞聚集;E-溶媒对照组肾脏;F-高剂量组肾脏,极轻度混合细胞聚集;G-溶媒对照组脾脏;H-高剂量组脾脏,轻度混合细胞聚集 。

, figureFileSmall=+jEB/WEOmRzO9fc+O1u+Vw==, figureFileBig=MhMYdVv/wBo7qcIarKRKwA==, tableContent=null), ArticleFig(id=1212799322723373225, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Fig.10, caption=GvHD and secondary histopathological changes induced by CIK cell injections(×200)

A-liver in vehicle control group; B-liver in the high dose group, mild mixed cell aggregation and moderate degeneration or necrosis of hepatocytes; C-spleen in vehicle control group; D-spleen in the high dose group, extremely mild mixed cell aggregation and mild fibrosis; E-skin in vehicle control group; F-skin in the high dose group, mild epidermal hyperplasia, extremely mild basal cell degeneration or necrosis; G-stomach in vehicle control group; H-stomach, fore stomach in the high dose group, extremely mild mixed cell aggregation, extremely mild inflammatory cell infiltration with basal cell degeneration or necrosis.

, figureFileSmall=rg6h+fUL+XOcIakhCihgMA==, figureFileBig=ODi8V37FRFIS9FMy2ah7NA==, tableContent=null), ArticleFig(id=1212799322832425130, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=图10, caption=CIK细胞注射后引发的GvHD及继发性组织病理改变(×200)

A-溶媒对照组肝脏;B-高剂量组肝脏,轻度混合细胞聚集、中度肝细胞变性或坏死 ;C-溶媒对照组脾脏;D-高剂量组脾脏,极轻度混合细胞聚集、轻度纤维化;E-溶媒对照组皮肤;F-高剂量组皮肤,轻度表皮增生、极轻度基底细胞变性或坏死;G-溶媒对照组胃;H-高剂量组胃、前胃、极轻度混合细胞聚集,极轻度炎性细胞浸润伴基底细胞变性或坏死。

, figureFileSmall=rg6h+fUL+XOcIakhCihgMA==, figureFileBig=ODi8V37FRFIS9FMy2ah7NA==, tableContent=null), ArticleFig(id=1212799323033751727, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Tab.1, caption=

Results of serum biochemical examination after repeated administration of CIK cells in NPG mice. n=10,$\stackrel{-}{x}$±s

, figureFileSmall=null, figureFileBig=null, tableContent=
Gender Male
Examination 1 d After the last administration End of recovery period
Period group Vehicle control group Low dose group High dose group Vehicle control group Low dose group High dose group
GGT/U·L-1 0.81 ±1.00 1.18 ±0.39 2.45 ±1.082) - - -
LDH/U·L-1 739 ±205 730 ±240 1 081 ±2911) 1 637 ±683 793 ±320 509 ±2951)
TBIL/μmol·L-1 5.35 ±1.04 5.18 ±0.87 2.97 ±0.512) - - -
BUN/mmol·L-1 7.3 ±0.9 7.0 ±1.0 12.3 ±2.72) 8.0 ±0.5 7.7 ±0.9 13.8 ±0.82)
GLU/mmol·L-1 7.63 ±0.82 8.42 ±1.84 5.93 ±1.261) - - -
CHO/mmol·L-1 2.21 ±0.47 2.15 ±0.30 1.39 ±0.052) - - -
TP/g·L-1 50.5 ±3.6 47.8 ±5.1 42.7 ±3.22) - - -
ALB/g·L-1 20.8 ±1.6 19.8 ±2.2 16.9 ±1.52) - - -
A/G 0.70 ±0.03 0.71 ±0.04 0.65 ±0.051) - - -
K+/mmol·L-1 5.23 ±0.39 4.63 ±0.79 4.06 ±0.602) - - -
Na+/mmol·L-1 153.7 ±1.7 153.8 ±2.8 158.9 ±4.02) 153.8 ±2.0 155.2 ±0.9 158.9 ±0.62)
Cl-/mmol·L-1 109.9 ±1.3 110.3 ±2.3 116.4 ±4.12) 114.0 ±3.0 113.8 ±0.9 119.8 ±0.41)
CK/U·L-1 - - - - - -
ALP/U·L-1 - - - - - -
TG/mmol·L-1 - - - - - -
LDH/U·L-1 1 165 ±229 926 ±166 755 ±3042) - - -
TBIL/μmol·L-1 4.68 ±1.03 4.82 ±2.90 3.50 ±1.041) - - -
BUN/mmol·L-1 7.2 ±1.0 7.9 ±1.4 9.5 ±1.72) 9.4 ±2.2 9.5 ±2.9 25.5 ±10.22)
GLU/mmol·L-1 5.25 ±0.93 6.79 ±1.191) 6.79 ±1.291) - - -
CHO/mmol·L-1 1.30 ±0.21 1.59 ±0.311) 1.32 ±0.25 - - -
TP/g·L-1 - - - - - -
ALB/g·L-1 21.7 ±1.9 21.2 ±2.1 18.9 ±1.12) - - -
A/G 0.85 ±0.05 0.81 ±0.07 0.74 ±0.042) - - -
K+/mmol·L-1 5.23 ±0.39 4.63 ±0.79 4.06 ±0.602) - - -
Na+/mmol·L-1 - - - - - -
Cl-/mmol·L-1 - - - 113.5 ±2.4 114.5 ±2.7 124.1 ±3.02)
CK/U·L-1 255 ±72 223 ±43 172 ±761) - - -
GGT/U·L-1 1.37 ±0.55 1.43 ±0.73 2.34 ±0.722) 1.81 ±0.33 1.79 ±0.36 2.72 ±0.591)
ALP/U·L-1 - - - 54 ±15 44 ±10 113 ±372)
TG/mmol·L-1 - - - 0.56 ±0.15 0.67 ±0.10 0.17 ±0.101)
), ArticleFig(id=1212799323151192242, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=表1, caption=

CIK重复给药后NPG小鼠血清生化检查结果。n=10,$\stackrel{-}{x}$±s

, figureFileSmall=null, figureFileBig=null, tableContent=
Gender Male
Examination 1 d After the last administration End of recovery period
Period group Vehicle control group Low dose group High dose group Vehicle control group Low dose group High dose group
GGT/U·L-1 0.81 ±1.00 1.18 ±0.39 2.45 ±1.082) - - -
LDH/U·L-1 739 ±205 730 ±240 1 081 ±2911) 1 637 ±683 793 ±320 509 ±2951)
TBIL/μmol·L-1 5.35 ±1.04 5.18 ±0.87 2.97 ±0.512) - - -
BUN/mmol·L-1 7.3 ±0.9 7.0 ±1.0 12.3 ±2.72) 8.0 ±0.5 7.7 ±0.9 13.8 ±0.82)
GLU/mmol·L-1 7.63 ±0.82 8.42 ±1.84 5.93 ±1.261) - - -
CHO/mmol·L-1 2.21 ±0.47 2.15 ±0.30 1.39 ±0.052) - - -
TP/g·L-1 50.5 ±3.6 47.8 ±5.1 42.7 ±3.22) - - -
ALB/g·L-1 20.8 ±1.6 19.8 ±2.2 16.9 ±1.52) - - -
A/G 0.70 ±0.03 0.71 ±0.04 0.65 ±0.051) - - -
K+/mmol·L-1 5.23 ±0.39 4.63 ±0.79 4.06 ±0.602) - - -
Na+/mmol·L-1 153.7 ±1.7 153.8 ±2.8 158.9 ±4.02) 153.8 ±2.0 155.2 ±0.9 158.9 ±0.62)
Cl-/mmol·L-1 109.9 ±1.3 110.3 ±2.3 116.4 ±4.12) 114.0 ±3.0 113.8 ±0.9 119.8 ±0.41)
CK/U·L-1 - - - - - -
ALP/U·L-1 - - - - - -
TG/mmol·L-1 - - - - - -
LDH/U·L-1 1 165 ±229 926 ±166 755 ±3042) - - -
TBIL/μmol·L-1 4.68 ±1.03 4.82 ±2.90 3.50 ±1.041) - - -
BUN/mmol·L-1 7.2 ±1.0 7.9 ±1.4 9.5 ±1.72) 9.4 ±2.2 9.5 ±2.9 25.5 ±10.22)
GLU/mmol·L-1 5.25 ±0.93 6.79 ±1.191) 6.79 ±1.291) - - -
CHO/mmol·L-1 1.30 ±0.21 1.59 ±0.311) 1.32 ±0.25 - - -
TP/g·L-1 - - - - - -
ALB/g·L-1 21.7 ±1.9 21.2 ±2.1 18.9 ±1.12) - - -
A/G 0.85 ±0.05 0.81 ±0.07 0.74 ±0.042) - - -
K+/mmol·L-1 5.23 ±0.39 4.63 ±0.79 4.06 ±0.602) - - -
Na+/mmol·L-1 - - - - - -
Cl-/mmol·L-1 - - - 113.5 ±2.4 114.5 ±2.7 124.1 ±3.02)
CK/U·L-1 255 ±72 223 ±43 172 ±761) - - -
GGT/U·L-1 1.37 ±0.55 1.43 ±0.73 2.34 ±0.722) 1.81 ±0.33 1.79 ±0.36 2.72 ±0.591)
ALP/U·L-1 - - - 54 ±15 44 ±10 113 ±372)
TG/mmol·L-1 - - - 0.56 ±0.15 0.67 ±0.10 0.17 ±0.101)
), ArticleFig(id=1212799323264438453, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Tab.2, caption=

The results of the hematology examination after repeated administration of CIK cells in NPG mice. n=10,$\stackrel{-}{x}$±s

, figureFileSmall=null, figureFileBig=null, tableContent=
Gender Male Female
Group Vehicle control group Low dose group High dose group Vehicle control group Low dose group High dose group
Lymph/% 72.3 ±3.1 73.5 ±5.2 88.4 ±10.82) 71.5 ±5.8 68.4 ±7.8 90.5 ±3.52)
MONO/109·L-1 0.01 ±0.01 0.01 ±0.01 0.07 ±0.051) 0 ±0.01 0.01 ±0.01 0.04 ±0.012)
HGB/g·L-1 125 ±8 125 ±6 91 ±271) 125 ±6 121 ±7 74 ±242)
HCT/% 39.8 ±2.3 39.7 ±2.0 28.3 ±8.41) 40.0 ±2.3 39.2 ±2.4 24.1 ±7.72)
MCV/fL 56.3 ±1.9 55.1 ±1.5 52.0 ±1.52) - - -
MCH/pg 17.8 ±0.7 17.3 ±0.4 16.6 ±0.52) - - -
PLT/109·L-1 742 ±150 804 ±307 394 ±1871) 742 ±128 785 ±56 316 ±2332)
MPV/fL 6.9 ±0.3 6.7 ±0.3 7.5 ±0.61) 6.9 ±0.4 6.8 ±0.2 7.8 ±0.22)
Baso/% 24.3 ±3.4 24.6 ±5.5 7.8 ±11.11) 26.2 ±5.7 29.4 ±7.5 2.3 ±3.62)
MONO/% - - - 0.7 ±1.3 1.2 ±1.2 6.5 ±4.72)
Baso/109·L-1 - - - 0.14 ±0.08 0.21 ±0.08 0.03 ±0.051)
RBC/1012·L-1 - - - 7.22 ±0.43 7.03 ±0.51 4.39 ±1.332)
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CIK重复给药后NPG小鼠血液学检查结果。n=10,$\stackrel{-}{x}$±s

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Gender Male Female
Group Vehicle control group Low dose group High dose group Vehicle control group Low dose group High dose group
Lymph/% 72.3 ±3.1 73.5 ±5.2 88.4 ±10.82) 71.5 ±5.8 68.4 ±7.8 90.5 ±3.52)
MONO/109·L-1 0.01 ±0.01 0.01 ±0.01 0.07 ±0.051) 0 ±0.01 0.01 ±0.01 0.04 ±0.012)
HGB/g·L-1 125 ±8 125 ±6 91 ±271) 125 ±6 121 ±7 74 ±242)
HCT/% 39.8 ±2.3 39.7 ±2.0 28.3 ±8.41) 40.0 ±2.3 39.2 ±2.4 24.1 ±7.72)
MCV/fL 56.3 ±1.9 55.1 ±1.5 52.0 ±1.52) - - -
MCH/pg 17.8 ±0.7 17.3 ±0.4 16.6 ±0.52) - - -
PLT/109·L-1 742 ±150 804 ±307 394 ±1871) 742 ±128 785 ±56 316 ±2332)
MPV/fL 6.9 ±0.3 6.7 ±0.3 7.5 ±0.61) 6.9 ±0.4 6.8 ±0.2 7.8 ±0.22)
Baso/% 24.3 ±3.4 24.6 ±5.5 7.8 ±11.11) 26.2 ±5.7 29.4 ±7.5 2.3 ±3.62)
MONO/% - - - 0.7 ±1.3 1.2 ±1.2 6.5 ±4.72)
Baso/109·L-1 - - - 0.14 ±0.08 0.21 ±0.08 0.03 ±0.051)
RBC/1012·L-1 - - - 7.22 ±0.43 7.03 ±0.51 4.39 ±1.332)
), ArticleFig(id=1212799323524485307, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=EN, label=Tab.3, caption=

NPG mice developed GVHD associated with CIK administration

, figureFileSmall=null, figureFileBig=null, tableContent=
Organ
/tissue
Related
lesion
Degree of
lesion
Frequency of lesion
Male Female
Vehicle
control
group
(n=10)
Low
dose
group
(n=10)
High
dose
group
(n=6)
Vehicle
control
group
(n=10)
Low
dose
group
(n=9)
High
dose
group
(n=6)
Spleen Fibrosis + 0 0 0 0 0 1
++ 0 0 0 0 0 2
Submandibular gland Decreased secretion of serous acinar cell ++ 0 0 3 0 0 2
+++ 0 0 2 0 0 2
Stomach Inflammatory cell infiltration in the cardia of the stomach with degeneration/necrosis of basal cells + 0 0 5 0 0 5
Sternum (bone marrow) Decreased bone marrow cells ++ 0 0 1 0 0 0
Bone (unilateral femur) Decreased bone marrow cells + 0 0 0 0 0 1
++ 0 0 2 0 0 0
Fibro-osseous lesion + 0 0 1 0 0 0
Skin Epithelial hyperplasia + 0 0 4 0 0 2
++ 0 0 1 0 0 4
Degeneration/necrosis of basal cells + 0 0 5 0 0 6
Skin at the site of dorsal hairloss Epithelial hyperplasia ++ - - - - - 1
Degeneration/necrosis of basal cells + - - - - - 1
), ArticleFig(id=1212799323641925822, tenantId=1146029695717560320, journalId=1190317699101192196, articleId=1212693338583646823, language=CN, label=表3, caption=

给药后NPG小鼠出现与给与CIK相关的移植物抗宿主反应(GvHD)反应

, figureFileSmall=null, figureFileBig=null, tableContent=
Organ
/tissue
Related
lesion
Degree of
lesion
Frequency of lesion
Male Female
Vehicle
control
group
(n=10)
Low
dose
group
(n=10)
High
dose
group
(n=6)
Vehicle
control
group
(n=10)
Low
dose
group
(n=9)
High
dose
group
(n=6)
Spleen Fibrosis + 0 0 0 0 0 1
++ 0 0 0 0 0 2
Submandibular gland Decreased secretion of serous acinar cell ++ 0 0 3 0 0 2
+++ 0 0 2 0 0 2
Stomach Inflammatory cell infiltration in the cardia of the stomach with degeneration/necrosis of basal cells + 0 0 5 0 0 5
Sternum (bone marrow) Decreased bone marrow cells ++ 0 0 1 0 0 0
Bone (unilateral femur) Decreased bone marrow cells + 0 0 0 0 0 1
++ 0 0 2 0 0 0
Fibro-osseous lesion + 0 0 1 0 0 0
Skin Epithelial hyperplasia + 0 0 4 0 0 2
++ 0 0 1 0 0 4
Degeneration/necrosis of basal cells + 0 0 5 0 0 6
Skin at the site of dorsal hairloss Epithelial hyperplasia ++ - - - - - 1
Degeneration/necrosis of basal cells + - - - - - 1
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CIK细胞在免疫缺陷NPG小鼠体内重复给药毒性研究
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黄瑛 1 , 刘静维 2 , 侯田田 1 , 文海若 1 , 秦超 1 , 卢戌 2, * , 耿兴超 1, *
中国药学杂志 | 细胞治疗产品评价专栏 2024,59(20): 1899-1909
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中国药学杂志 | 细胞治疗产品评价专栏 2024, 59(20): 1899-1909
CIK细胞在免疫缺陷NPG小鼠体内重复给药毒性研究
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黄瑛1, 刘静维2, 侯田田1, 文海若1, 秦超1, 卢戌2, *, 耿兴超1, *
作者信息
  • 1 中国食品药品检定研究院, 国家药物安全评价监测中心,药物非临床安全评价研究北京市重点实验室, 北京 100176
  • 2 康爱瑞浩生物医药(浙江)股份有限公司, 浙江 嘉兴 314100
  • 黄瑛,女,博士,副研究员 研究方向:药物毒理研究

通讯作者:

* 卢戌,男,博士,正高级工程师 研究方向:生物医药开发研究 Tel:(010)80498890;
耿兴超,男,博士,研究员 研究方向:药物毒理研究 Tel:(010)62876255
Toxicity Study of Cytokine Induced Killer Cells in Immunodeficient NPG Mice
Ying HUANG1, Jingwei LIU2, Tiantian HOU1, Hairuo WEN1, Chao QIN1, Xu LU2, *, Xingchao GENG1, *
Affiliations
  • 1 The Beijing Key Lab for Pre-clinical Safety Evaluation of Drugs, National Center for Safety Evaluation of Drugs, National Institutes for Food and Drug Control, Beijing 100176, China
  • 2 Karh Biohealthcare Biotechnology (Zhejiang) Co., Ltd., Jiaxing 314100, China
出版时间: 2024-10-22 doi: 10.11669/cpj.2024.20.003
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目的 采用重度免疫缺陷NPG小鼠模型对细胞因子诱导的杀伤性(CIK)细胞治疗产品进行毒性研究,考察多次给药后的毒性反应,为临床应用提供安全性依据。方法 采用NPG小鼠,设主实验组和卫星组两个大组,每大组分为溶媒对照组、低剂量组(每只小鼠给予2×106个细胞)和高剂量组(每只小鼠给予3×107个细胞)。每两周给药1次,共给药6次,恢复期28 d。实验期间,主实验组动物进行临床症状观察、体质量和摄食量测定,并于给药期结束和恢复期结束后解剖采血,进行血液学和血清生化检查、细胞因子检测、脏器称重和病理学检查。卫星组动物于首次给药和末次给药前、给药后3 h、1、3、10 d以及恢复期结束后采血,进行细胞表型分析,以考察CIK细胞的分布情况。结果 在低剂量组重复给药6次,小鼠未见明显毒性反应,仅个别动物出现弓背、摄食量下降和葡萄糖(GLU)、总胆固醇(CHO)升高等症状,血液中仅在首次给药后1 d和末次给药后个别时间点(3 h、10 d、29 d)检测到少量CIK细胞。高剂量组重复给药6次,小鼠血液中可检测较高水平的CIK细胞,血清中γ-干扰素(IFN-γ)、肿瘤坏死因子(TNF)、白细胞介素10(IL-10),白细胞介素2(IL-2)等具有肿瘤杀伤作用的细胞因子升高,同时小鼠出现明显的移植物抗宿主反应(graft-versus-host disease,GvHD),表现为动物临床症状、体质量、摄食量、血液学和血清生化等多个指标的变化、动物多脏器发生混合细胞聚集和GvHD相关的病变。结论 NPG小鼠重复给予CIK细胞,在每只小鼠给予2×106个细胞的剂量(临床拟用剂量)下动物未见显著的毒性反应;在每只小鼠给予3×107个细胞剂量下动物出现与异种细胞移植相关的GvHD反应,未见其他相关的毒理学反应。该结果为CIK细胞进入临床试验奠定了基础。

细胞治疗  /  细胞因子诱导的杀伤性细胞  /  免疫缺陷小鼠  /  安全性

OBJECTVIE To provide safety basis for clinical application, and evaluate the toxicity CIK cells by repeated administration of CIK cells in severe immunodeficient NPG mouse model. METHODS The NPG mice were randomized into two groups: the main experimental group and the satellite group. Each group was divided into vehicle control group, low dose group (2×106 cells per mouse) and high dose group (3×107 cells per mouse). The CIK cells were given every two weeks for 6 times with 28-day recovery. During the experiment, the clinical symptoms, body weight and food intake were observed in the main experimental group. Blood samples were dissected and collected at the end of the administration period and recovery period, and the hematology, serum biochemical examination, cytokine detection, organ weighing and pathological examination were performed. The blood samples of satellite animals were collected to investigate the distribution of CIK cells before the first and last administration, 3 h, 1 d, 3 d, 10 d after the administration, and after the recovery period. RESULTS After repeated administration for 6 times at low dose, no obvious toxic reaction was observed in mice. A few CIK cells were detected in the blood at 1 day after the first dose and at some time points (3 h, day 10, day 29) after the last dose. High levels of CIK cells were detected in the blood of mice after repeated administration of 6 times at high dose. The levels of IFN-γ, TNF, IL-10, IL-2 and Il-10 in serum were increased. At the same time, significant graft-versus-host disease (GvHD) reaction was observed in mice, including the changes of clinical symptoms, body weight, food intake, hematology and serum biochemistry, mixed cell aggregation and GvHD-related lesions occurred in multiple organs of animals. CONCLUSION The data from the study indicates that no significant toxic reaction was observed at the dose of 2×106 cells per mouse (the clinical dosage). GvHD associated with xenotransplantation was observed at a dose of 3×107 cells per mouse, and no other related toxicity was observed. These data will facilitate CIK cells to enter into clinical trials.

immunocyte therapy  /  CIK cells  /  immunodeficient mice  /  safety
黄瑛, 刘静维, 侯田田, 文海若, 秦超, 卢戌, 耿兴超. CIK细胞在免疫缺陷NPG小鼠体内重复给药毒性研究. 中国药学杂志, 2024 , 59 (20) : 1899 -1909 . DOI: 10.11669/cpj.2024.20.003
Ying HUANG, Jingwei LIU, Tiantian HOU, Hairuo WEN, Chao QIN, Xu LU, Xingchao GENG. Toxicity Study of Cytokine Induced Killer Cells in Immunodeficient NPG Mice[J]. Chinese Pharmaceutical Journal, 2024 , 59 (20) : 1899 -1909 . DOI: 10.11669/cpj.2024.20.003
细胞因子诱导的杀伤性(cytokine-induced killer, CIK)细胞是将人外周血单核细胞在体外条件下经γ-干扰素(IFN-γ)、白细胞介素2(IL-2)、抗CD3单抗等多种细胞因子刺激作用后获得,通过诱导肿瘤细胞裂解并分泌多种具有直接细胞毒活性或抑制作用的细胞因子的方式,发挥抗肿瘤活性[1-4]。作为一种过继性细胞疗法,将体外培养的CIK细胞回输至患者体内后,对血液瘤和实体瘤均有显著的治疗效果[5-7]。同时,商品化使用的CIK细胞治疗产品多为患者自体同源细胞诱导培养,在临床应用的过程中不会造成患者出现免疫排斥或移植物抗宿主反应(graft-versus-host disease,GvHD)等不良反应,具有理想的抗肿瘤药物特性,故CIK细胞是目前免疫细胞治疗领域极具热点的研究方向之一[8-11]
免疫细胞治疗产品的非临床安全性评价是推进其临床转化应用的关键环节,尽管已有多项研究使用不同的动物模型进行了不同制备方式的CIK细胞的药效和毒理学研究[12],但是这些研究只是在使用少量动物模型的基础上进行的药效评价和简化的安全性评价,仍处于实验研究的阶段,并没有建立符合非临床研究规范的实验动物模型和检测指标,多数实验条件也无法达到药物非临床研究质量管理规范(good laboratory practice, GLP)的要求。另外,针对不同的CIK细胞产品,都需要进行独立的非临床研究实验。为此,本研究在符合GLP要求的实验条件下,使用免疫缺陷NPG小鼠模型对1例特定的CIK细胞治疗产品进行了生物分布研究和重复给药毒理学研究,完善了该产品的非临床研究数据,为开展该产品和其他CIK细胞治疗产品的非临床研究提供了支持,也为该产品进行新药临床试验申请(IND)申报并设计临床试验中人用剂量和毒副反应监测提供了数据支持和参考依据。
CIK细胞注射液,浓度分别为每毫升5×106、7.5×107个细胞,浅黄色半透明细胞混悬液,4~8 ℃保存,给药当天制备[康爱瑞浩生物医药(浙江)股份有限公司]。
CIK细胞溶媒,0.9%氯化钠注射液(含体积分数20%人血白蛋白注射液),浅黄色透明液体,4~8 ℃保存,给药当天制备[康爱瑞浩生物医药(浙江)股份有限公司]。
Per-CP mouse anti-human CD3(批号:8124735)、PE mouse anti-human CD4(批号:9172628)、FITC mouse anti-muman CD8(批号:7312538)、Th1/Th2细胞因子检测试剂盒(批号:551809)(美国BD Pharmingen公司);Anti-human CD45(批号:2138102,深圳NeoBioscience公司)。
流式细胞仪(型号:FACS Calibur,美国BD公司);自动生化分析仪(型号:HITACHI 7180,日本日立公司);血液检查仪(型号:ADVIA120,德国西门子公司);脱水机(型号:LEICA ASP300)、切片机(型号:SAKURAIVS-410)、全自动染色机(型号:SAKURA Tissue-TekDRS-2000)、包埋机(型号:SAKURA Tecc 4714)、封片机(型号:SAKURA Tissue-TEKGLAS C410)(日本樱花公司);生物显微镜(型号:OLYMPUS BX51,日本奥林巴斯公司)。
NPG小鼠270只,雌雄各半,5~6周龄,体质量约18~27 g,购于北京维通达生物技术有限公司,实验动物生产许可证号:SCXK(京)2019-0002。动物质量合格证号:1103412011000507。动物饲养于SPF屏障系统,每天上、下午各1次对动物进行观察,饲养室12 h照明,温度20~25 ℃,日温差≤3 ℃,湿度40%~70%,换气次数每小时10~20次。
试验共使用270只小鼠,根据不同测定项目分别分为主实验组和卫星组两大项目组,每个大项目组设置3个剂量组:溶媒对照组、低剂量(每只动物给予2×106个细胞)组及高剂量(每只动物给予3×10个细胞)组。主实验组进行常规毒性检查、血清生化测定、血液学测定、细胞因子测定和病理学检查;卫星组进行细胞因子、CIK细胞表型测定。各组动物尾静脉注射给予溶媒或CIK细胞注射液,每2周给药1次,共给药6次,给药体积为每只动物400 μL。恢复期为28 d。实验设计概况见图1
首次给药和末次给药前、给药后3 h、1、3、10 d;末次给药后29 d对卫星组动物采血,每管样本加入荧光标记CD3+/CD4+/CD8+抗体5 μL,避光孵育20 min,加入适量磷酸缓冲盐溶液(PBS)洗液,1 000 r·min-1离心5 min,弃上清,反复洗涤2次,用FACS Calibur 流式细胞仪检测CD3+、CD4+、CD8+细胞的数量。
首次给药后第30天、末次给药后第1天、末次给药后第29天对动物采血,应用Th1/Th2细胞因子检测试剂盒进行人源细胞因子IFN-γ、IL-6、IL-10、IL-2、TNF、IL-4测定。按照试剂盒说明书推荐操作步骤进行,在流式管中加入50 μL混合微球;在标准品管中,每管加入50 μL标准品系列液(S1~S10),在样本管中,每管加入50 μL待测血清;所有实验管加入50 μL Th1/Th2-II PE检测试剂。加入后,用手轻弹混匀; 置于室温避光孵育3 h。孵育结束,每管加入1 mL洗液,用手轻弹样本管,200 r·min-1 离心5 min;离心后小心倾倒上清液,每管加入300 μL洗液,用手重悬微球,上机测定。
对于预定解剖动物麻醉后(腹腔注射硫喷妥钠,麻醉剂量60 mg·kg-1)先采血,经腹腔后大静脉采血后,完全放血处死后进行解剖,摘取脏器后直接固定,睾丸、附睾、眼球用Davidson's固定液固定,其他脏器用体积分数10%中性甲醛固定,组织经修块取材,逐级乙醇脱水,石蜡包埋,滑动切片机切片(厚约3 μm),经苏木精-伊红(HE)染色,光镜检查。
对于体质量、摄食量、血液学指标、血清生化检查、绝对脏器重量和相对脏器质量、细胞因子测定等数据均按照以下方法统计:①首先用Bartlett 检验方法进行数据均一性检验,如果数据均一(检验P>0.05),则进行方差分析检验(F检验);如果Bartlett 检验的结果显著(P≤0.05),则进行Kruskal-wallis检验;②如果方差分析检验结果显著(P≤0.05),则进一步用Dunnett参数检验法进行多重比较检验;如果方差分析结果不显著(P>0.05),则统计结束;③如果Kruskal-wallis检验结果显著(P≤0.05),则进一步用Dunnett非参数检验法进行多重比较检验;如果Kruskal-wallis检验结果不显著(P>0.05),则统计结束。
低剂量组雌性动物个别动物出现弓背,高剂量组动物试验期间多出现弓背、竖毛、脱毛、活动减少、双侧眯眼、死亡(图2),结合组织病理学检查发现动物多组织器官可见混合细胞聚集,以及多个组织器官变性或坏死以及纤维化等组织病理学改变,认为上述症状与受试物细胞给予后在各组织器官的滞留以及受试物(人源细胞)给予NPG小鼠后产生GvHD反应相关。
与溶媒对照组相比,给药期给药第45天至第66天,高剂量组的雄性动物体质量显著下降(P<0.01);给药第38天至第66天,高剂量组的雌性动物体质量显著下降(P<0.01)。恢复期第3天至第28天,高剂量组的雄性动物和雌性动物体质量与同期溶媒对照组动物相比体质量均显著下降(P<0.05,P<0.01),低剂量组雌性动物体质量也有降低趋势。见图3
与溶媒对照组相比,低剂量动物给药期摄食量未见统计学差异,但雌性动物恢复期第23天摄食量显著下降(P<0.05)且恢复期第16天与溶媒对照组相比也有一定程度下降,恢复期结束时(第28天)动物摄食量有所恢复,见图4
与溶媒对照组相比,高剂量组雄性动物给药第45天摄食量显著下降(P<0.05),给药第31天、第38天、第52天和第59天摄食量与溶媒对照组相比也有下降的趋势。与溶媒对照组相比,恢复期第16天,高剂量组雄性动物摄食量显著下降(P<0.05),但恢复期结束时(第28天)雄性动物摄食量恢复。与溶媒对照组相比,高剂量组雌性动物给药第45天摄食量显著下降(P<0.05),给药第17天至第38天、第52天和第59天摄食量与溶媒对照组相比也有下降趋势。恢复期第3天至第28天,高剂量组雌性动物摄食量基本恢复正常。
血清生化检测见表1,与溶媒对照组相比,CIK细胞在每只动物给予2×106个细胞的剂量下引起血糖(GLU)、总胆固醇(CHO)显著升高(P<0.05);在每只动物给予3×107个细胞的剂量下引起谷氨酰转肽酶(GGT)、尿素氮(BUN)、Na 离子(Na+)、Cl 离子(Cl-)显著升高(P<0.01),肌酸磷酸激酶(CK)、总胆红素(TBIL)、CHO、总蛋白质(TP)、白蛋白(ALB)、白蛋白/球蛋白(A/G)、钾离子(K+)、甘油三酯(TG)显著降低(P<0.05,P<0.01),还会引起乳酸脱氢酶(LDH)和GLU的显著改变(升高/降低)(P<0.05,P<0.01),结合组织病理学检查结果进行分析,认为上述血液指标改变与CIK细胞给予后在各组织器官的滞留以及CIK细胞(人源细胞)给予小鼠后产生GvHD反应相关。
血液学检测见表2,与溶媒对照组相比,CIK细胞在每只动物给予2×106个细胞的剂量下对血液学指标无显著影响,在每只动物给予3×107个细胞的剂量下会引起动物淋巴细胞百分率(LYMP%)、单核细胞(MONO)、单核细胞百分率(MONO%)、平均血小板体积(MPV)显著升高,嗜碱性粒细胞(BASO)、嗜碱性粒细胞百分率(BASO%)、红细胞(RBC)、血红蛋白浓度(HGB)、红细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白量(MCH)、血小板(PLT)显著降低,且上述血液指标的变化在雌雄动物间具有较好的一致性。结合组织病理学检查结果进行分析,认为上述血液学指标改变与CIK细胞给予后在各组织器官的滞留以及CIK细胞(人源细胞)给予小鼠后产生GvHD反应相关。
血液中CIK细胞分布(CD3+CD4+/CD3+CD8+细胞)检测结果见图5~6,首次给药后3 h,高剂量组动物血液中即可检测到CIK细胞,1 d后细胞水平达高峰,随后逐渐下降。末次给药前,高剂量组雄性和雌性动物血液中均可检测到较高水平的CIK细胞。末次给药后3 h,高剂量组雄性动物外周血中CIK细胞含量略有下降,给药1 d时再次达峰,随后逐渐下降;末次给药后3 h~1 d,高剂量组雌性动物外周血中CIK细胞含量逐渐下降,给药后3~10 d再次达峰,随后逐渐下降。低剂量组,仅首次给药后1 d和末次给药后个别时间点(3 h、10 d、29 d)可检测到少量CIK细胞。
人源细胞因子检测(图7):每只小鼠给予2×106个CIK细胞的剂量下,对小鼠血清中人源IFN-γ、TNF、IL-10、IL-6、IL-4、IL-2细胞因子水平无显著影响;在3×107个CIK细胞的剂量下,可能会使NPG小鼠血清中人源因子IFN-γ、TNF、IL-10、IL-2水平显著升高(P<0.01),CIK细胞属于人源T淋巴细胞,结合组织病理学结果分析,上述细胞因子水平变化可能与CIK细胞体内药效学作用以及CIK细胞(人源细胞)给予小鼠后产生GvHD反应等多种因素相关。
鼠源细胞因子检测(图8):每只小鼠给予2×106 CIK细胞的剂量下,对小鼠血清中鼠源IL-10、IL-17A、IFN-γ、TNF、IL-6、IL-4、IL-2细胞因子无显著影响;在3×107 CIK细胞的剂量下,可能会使小鼠血清中鼠源因子TNF、IL-6水平升高(P<0.01),考虑这一变化与给予异种细胞后机体产生的免疫应答反应相关。
病理学检查结果见图9,给予CIK细胞会引起多个组织器官[如肝脏、胆囊、肾脏、肺(含支气管)、脾脏、心脏、颌下腺、胃、甲状腺、垂体、食道、舌、气管、胸骨(骨髓)、骨(单侧大腿骨)、睾丸、附睾、前列腺、精囊腺、卵巢、输卵管、子宫(带子宫颈)、阴道、膀胱、肾上腺、肌肉(骨骼肌)、坐骨神经、皮肤、脑、注射部位]混合细胞聚集;给予人源CIK细胞后引起的GvHD及继发性病理改变见表3图10,包括肝脏肝细胞变性或坏死及纤维化,脾脏纤维化,舌基底细胞变性或坏死,前胃炎性细胞浸润伴基底细胞变性或坏死及基底细胞变性或坏死,皮肤表皮增生、基底细胞变性或坏死,颌下腺浆液性腺泡分泌减少,胸骨(骨髓)和骨(单侧大腿骨)骨髓细胞数目减少、纤维-骨性病变以及皮肤皮下、脑和脊髓(颈胸腰段)出血。
在非临床研究中,选择合适的动物种属可提高动物试验对于临床不良反应的预测性。本试验采用的NPG小鼠属于重度免疫缺陷小鼠,其体内不含T、B和NK细胞,可降低人源细胞输入引发的免疫排斥反应程度,可用于移植人源细胞或组织,适用于细胞治疗产品的毒性评价[15]
在给药剂量方面,本实验研究的CIK细胞注射液的临床用量主要根据回输细胞量占人外周血单个核细胞(peripheral blood mononuclear cell, PBMC)数的比例推算,因为人拟用剂量4×109个细胞(约等同于人PBMC数),小鼠每只PBMC数大约是每只106个细胞,故可据此推算的每只小鼠相当于人临床回输的剂量约106个细胞,即每千克5×107个细胞(小鼠体质量按20 g计算)。低剂量组每只小鼠给予2×106个细胞(约相当于人用剂量的2倍)。为尽量观测出CIK细胞注射液可能的毒性反应,按照单次给药毒性试验结果,本实验采用低剂量的15倍,即每只小鼠给予3×107个细胞作为给药的高剂量。本CIK细胞注射液临床拟用药方案为约间隔21 d进行1次静脉注射,最多给药约6次(6个疗程)。为最大限度模拟临床给药方式,结合动物实验特点,本实验采用尾静脉注射的给药方式,给药频率设为每2周1次,给药10周,共给药6次,恢复期设为28 d(约1个月)。
综合动物临床症状、体质量和摄食量结果分析,低剂量组动物出现弓背、摄食量下降;高剂量组动物出现弓背、竖毛、脱毛、活动减少、双侧眯眼、头向一侧倾斜、动物体质量和摄食量下降以及死亡等症状。结合组织病理学检查结果,考虑上述症状与CIK细胞注射后在各组织器官的大量滞留并引起GvHD反应有关。高剂量组与低剂量组相比,在实验期间有更多的动物出现了更多样更严重的不良反应,这表明每只小鼠给予3×107个细胞的剂量下,CIK细胞会引起动物明显的GvHD反应。
CIK细胞注射液在低剂量下会引起动物GLU、CHO显著升高,在高剂量下会引起血液学指标中LYMP%、MONO、MONO%、MPV显著升高和BASO、BASO%、RBC、HGB、HCT、MCV、MCH、PLT显著降低;血清生化指标中GGT、BUN、Na+、Cl-显著升高、CK、TBIL、CHO、TP、ALB、A/G、K+显著降低以及LDH和GLU的显著改变(升高/降低),这是由于在高剂量注射下,CIK细胞在血液和各器官中的滞留以及小鼠的GvHD反应造成的血液与骨髓抑制和脏器病变引起的。
血液中CIK细胞数量(CD3+CD4+、CD3+CD8+)检测结果显示,CIK细胞在低剂量和高剂量不同注射条件下,动物血液中细胞数量差距较大,在低剂量下,各类细胞数量始终处于低水平;在高剂量下,各类细胞数量显著提升,但此剂量造成的毒性反应同时也急剧增强,这表明本实验中CIK细胞的两个注射剂量均有一定的局限性,后续实验仍要继续探索CIK细胞的最佳给药剂量。
细胞因子检测结果表明,CIK细胞注射后会使小鼠血清中人源细胞因子IFN-γ、TNF、IL-10、IL-2水平升高,这些细胞因子均参与体内抗肿瘤过程,证明了该细胞的体内药效学作用。此外,CIK细胞还会使小鼠血清中鼠源细胞因子TNF、IL-6水平显著升高,这表明给予异种细胞后,NPG小鼠仍会产生一定的免疫应答。
CIK细胞注射后可引起动物多脏器重量改变和形态学变化,病理学检查结果显示,给予CIK细胞注射液引起了小鼠体内多脏器的混合细胞聚集,其形态学改变体现了CIK细胞的药效学作用和毒性作用过程,建议临床试验时加强关注。由于本研究中所使用的细胞为人源,给予NPG小鼠后引发了GvHD和一系列继发性病理改变。
GvHD最早即是在小鼠模型上观察到的[17],其产生的主要原因是供体T细胞识别宿主抗原触发了免疫反应,从而对宿主自身组织和器官进行攻击。临床表现上,GvHD多发于皮肤、口腔、眼睛、肝脏、胃肠道、肌肉、骨骼、肺、造血系统及泌尿生殖系统等器官和组织[18]。尽管本试验使用的是重度免疫缺陷小鼠,但在高剂量的异种CIK细胞注射下,仍会引发严重的GvHD反应,病理学检查结果也可见上述部位的病变。这将在一定程度上影响动物的生存期,缩短毒性试验观察周期,因此免疫缺陷小鼠在异种CIK细胞非临床安全性评价中仍然有一定的局限性,有待未来进一步探索和不断完善。有报道使用动物源CIK细胞进行小鼠体内试验的结果显示,这种方法制备的细胞不会引起动物的GvHD[19]。但是在非临床安全性评价的过程中,动物源CIK细胞需要专门制备并详细地提供与人源CIK细胞的对比数据以保证质量标准如一,增加了非临床试验的步骤和成本。人源化动物模型需要对动物进行相当复杂的转基因和移植操作[20],虽然可以使用人源CIK细胞进行研究并降低GvHD发生的概率,但存在动物模型不稳定等问题,增加了实验的难度。因此,在今后的CIK细胞非临床研究中,试验受试物和动物模型的选择仍需要继续探索,完善非临床安全性研究的数据。
综上所述,本研究使用免疫缺陷小鼠全面评估了CIK细胞的体内毒性风险,研究结果提示,CIK细胞在模拟人用剂量的注射条件(每只小鼠给予2×106 个细胞)下重复给药6次,不会引起小鼠明显的毒性反应;在每只小鼠给予3×107个细胞剂量下,小鼠会产生与异种移植相关的GvHD反应,未见其他相关的毒理学反应。该研究数据用于支持CIK细胞向国家药品监督管理局申报研究性新药申请,并已获准在国内开展临床试验。
  • 国家重点研发计划课题资助(2021YFA1101602)
  • 中国食品药品检定研究院关键技术研究基金资助(GJJS-2022-6-1)
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2024年第59卷第20期
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doi: 10.11669/cpj.2024.20.003
  • 接收时间:2024-06-28
  • 首发时间:2025-12-30
  • 出版时间:2024-10-22
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  • 收稿日期:2024-06-28
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国家重点研发计划课题资助(2021YFA1101602)
中国食品药品检定研究院关键技术研究基金资助(GJJS-2022-6-1)
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    1 中国食品药品检定研究院, 国家药物安全评价监测中心,药物非临床安全评价研究北京市重点实验室, 北京 100176
    2 康爱瑞浩生物医药(浙江)股份有限公司, 浙江 嘉兴 314100

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* 卢戌,男,博士,正高级工程师 研究方向:生物医药开发研究 Tel:(010)80498890;
耿兴超,男,博士,研究员 研究方向:药物毒理研究 Tel:(010)62876255
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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
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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