ABSTRACT
【Objective】 To learn more about the role of therapeutic plasma exchange in the management of cytokines release syndrome(CRS) after chimeric antigen receptor T(CAR-T) infusion by reviewing and analyzing the diagnosis and treatment of one case. 【Methods】 The diagnosis and treatment of lymphoma patients with CAR-T infusion related CRS were described, and case analysis was carried out by searching PubMed, Elsevier, Wiley, CNKI, and other databases for relevant guidelines, clinical trials, and case reports. 【Results】 The patient was diagnosed with follicular cell lymphoma. Progressive disease(PD) was assessed after multiple courses of treatment, and anti-CD19/20 CAR-T cell therapy was administered.The patient developed a high fever and chills, secondary dyspnea and hypotension at night on the day of infusion, and the inflammatory factors such as C-reactive protein(CRP) and interleukin-6(IL-6) increased sharply, suggesting the occurrence of cytokines release syndrome(CRS). After the patient was given symptomatic antipyretic, broad-spectrum anti-infection, tumor necrosis factor(TNF) antibody and three occasions of plasma exchange, the clinical manifestations of CRS gradually relieved. Three months after discharge, the patient was in complete response(CR). 【Conclusion】 CAR-T-associated CRS is a serious cellular immunotherapy-related toxicity that can result in multiple organ failure or even death in patients. Therapeutic plasma exchange may be a potential treatment for some patients with severe CRS.
ABSTRACT
ObjectiveTo investigate whether γδ T cells act as a regulatory factor during respiratory syncytial virus (RSV) infections was responsible for the subsequent changes in asthmatic-type inflammation in allergic mice.MethodsMice were sensitized and challenged with OVA,and infected intranasaly with RSV before or after OVA sensitization.Lung sections were stained with HE for determination of inflammatory reaction.Real-time RT-PCR was used to analyze the expression of cytokine mRNA of γδ T cells in the lung and spleen of tested mice.The number of γδ T cells in the spleen and lung of BALB/c mice was determined by flow cytometry.Adoptive transfer of γδ T cells was performed to identify the role of γδ T cells in allergic asthma.ResultsOVA-sensitized and challenged mice exhibited significantly peribronchial inflammation with larger number of mononuclear cells and granulocytes in the lung tissue sections.RSV infection before OVA-sensitization diminished the grade of inflammatory responses induced by OVA treatment.The expression of IFN-γ mRNA was increased siguificantly in RSV-infected,OVA-sensitized mice.In contrast,the level of IL-4 mRNA was diminished.The number of total γδ T cells as well as activated γδ T cells was decreased in the spleen and lung of OVA-sensitized mice by prior RSV infection.Adoptive transfer of γδ T cells obtained from OVA-sensitized and challenged mice induced a slight inflammation in the lung of normal mice,and enhanced inflammatory responses in RSV-infected OVA-sensitized mice.Conclusionγδ T cells may play an important role in the development of allergen-induced allergic airway inflammation.