ABSTRACT
Tumor recurrence is one of the major life-threatening complications after liver transplantation for liver cancer. In addition to the common mechanisms underlying tumor recurrence, another unavoidable problem is that the immunosuppressive therapeutic regimen after transplantation could promote tumor recurrence and metastasis. Transplant oncology is an emerging field that addresses oncological challenges in transplantation. In this context, a comprehensive therapeutic management approach is required to balance the anti-tumor treatment and immunosuppressive status of recipients. Double-negative T cells (DNTs) are a cluster of heterogeneous cells mainly consisting of two subsets stratified by T cell receptor (TCR) type. Among them, TCRαβ+ DNTs are considered to induce immune suppression in immune-mediated diseases, while TCRγδ+ DNTs are widely recognized as tumor killers. As a composite cell therapy, healthy donor-derived DNTs can be propagated to therapeutic numbers in vitro and applied for the treatment of several malignancies without impairing normal tissues or being rejected by the host. In this work, we summarized the biological characteristics and functions of DNTs in oncology, immunology, and transplantation. Based on the multiple roles of DNTs, we propose that a new balance could be achieved in liver transplant oncology using them as an off-the-shelf adoptive cell therapy (ACT).
Subject(s)
Humans , T-Lymphocytes , Immunotherapy, Adoptive , Neoplasm Recurrence, Local , Transplantation, Homologous , Cell- and Tissue-Based TherapyABSTRACT
Liver transplantation remains as the first choice treatment for patients with end stage liver diseases. Sarcopenia is a skeletal muscle disease characterized by loss of muscle mass and muscle function. As a common but easily overlooked complication, sarcopenia significantly influences the death and prognosis of recipients with cirrhosis and liver cancer waiting liver trans-plantation, which significantly influences the death and prognosis of those patients. Scientific evalua-tion and fine stratification of sarcopenia are expected to achieve precision intervention and improve prognosis of liver transplantation recipients.As sarcopenia is increasingly important in perioperative as well as medium and long-term management of liver transplantation recipients, it should be incorporated into normalized clinical diagnosis and treatment system. The authors review the research results at home and abroad, and comprehensively expound the research progress of sarcopenia in liver transplantation, in order to improve the cognition of sarcopenia in liver transplan-tation recipients in China.