CAR T-cell: a new approach of cancer therapy and it’s side effects

A novel immunotherapy approach is called CAR(Chimeric Antigen receptor) T-cell. CAR T cells are a living drug because the backbone of CAR T-cells are engineered T cells with an antibody single-chain variable fragment (ScFv) extracellular domain that binds tumor-associated antigens. CAR-T cells are activate with C-terminal to ScFv co-activation domains (CD28, 4-1BB, CD27, and others) and activation domains, inducing T-cell-killing machinery with cytokine and granzyme secretion.These special receptors allow them to recognize and attach to a specific antigen on tumor cells. The CAR on the cell’s surface is composed of fragments, or domains, of synthetic antibodies.Several research groups are testing T cells that target both CD22 and CD19 or CD123 in early-phase clinical trials.Like all cancer therapies, CAR T-cell therapy can cause several side effects. One of the most frequent problems is cytokine release syndrome (CRS). CRS can cause fever, low blood pressure, problems with breathing. Another potential side effect of CAR T-cell therapy—an off-target effect—is a mass die off of B cells, that researchers have known as B-cell aplasia.Other side effects are swelling in the brain, or cerebral edema, neurologic problems. Researchers are using nanotechnology to create CAR T cells inside the body, developing CAR T cells with off switches as a means of limiting side effects like CRS, and using of T-cell with genetic modification may happen either via viral-based gene transfer methods or non-viral methods, such as DNA-based transposons, CRISPR/Cas9 technology or direct transfer of in vitro transcribed-mRNA by electroporation.

Keywords:

CAR T cells , Side effects , Cytokine release syndrome , Cancer