{"id":35397,"date":"2020-06-22T00:00:18","date_gmt":"2020-06-21T16:00:18","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=35397"},"modified":"2020-06-19T13:53:19","modified_gmt":"2020-06-19T05:53:19","slug":"%e8%88%87%e5%b7%a8%e7%b4%b0%e8%83%9e%e7%97%85%e6%af%92%e6%84%9f%e6%9f%93%e6%9c%89%e9%97%9c%e4%b9%8b%e8%85%a6%e7%98%a4%e5%85%8d%e7%96%ab%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=35397","title":{"rendered":"\u8207\u5de8\u7d30\u80de\u75c5\u6bd2\u611f\u67d3\u6709\u95dc\u4e4b\u8166\u7624\u514d\u75ab\u6cbb\u7642"},"content":{"rendered":"

\u8166\u7624\u662f\u6307\u982d\u9871\u5167\u4e4b\u816b\u7624\uff0c\u4f9d\u7d30\u80de\u751f\u9577\u8d77\u6e90\u53ef\u5206\u70ba\u539f\u767c\u53ca\u8f49\u79fb\u6027\uff0c\u518d\u4f9d\u75c5\u7406\u5206\u5316\u53c8\u5c07\u539f\u767c\u6027\u8166\u7624\u5206\u70ba\u826f\u6027\u53ca\u60e1\u6027\uff0c\u6cbb\u7642\u65b9\u5f0f\u4e3b\u8981\u5305\u62ec\u5916\u79d1\u624b\u8853\u3001\u653e\u5c04\u7dda\u3001\u5316\u5b78\u3001\u514d\u75ab\u6cbb\u7642\u6216\u6df7\u5408\u7642\u6cd5\u3002\u76ee\u524d\u6a19\u6e96\u6cbb\u7642\u662f\u4ee5\u53e3\u670d\u66ff\u83ab\u5511\u80fatemozolomide\u4f5c\u70ba\u653e\u5c04\u6cbb\u7642\u4e4b\u8f14\u52a9\u6027\u5316\u5b78\u6cbb\u7642\uff0c\u800c\u514d\u75ab\u7642\u6cd5\u53ea\u9650\u65bc\u9ed1\u8272\u7d20\u7624\u3001\u814e\u7d30\u80de\u764c\u6216\u80ba\u764c\u4f75\u767c\u8166\u8f49\u79fb\u6642\u4f7f\u7528\uff0c\u7528\u65bc\u539f\u767c\u6027\u60e1\u6027\u8166\u7624\u6210\u6548\u4ecd\u4e0d\u4f73\u3002\u672c\u6587\u5c07\u4ecb\u7d39\u514d\u75ab\u6cbb\u7642\u7528\u65bc\u8207\u5de8\u7d30\u80de\u75c5\u6bd2\u611f\u67d3\u6709\u95dc\u4e4b\u8166\u7624\u7684\u81e8\u5e8a\u6848\u4f8b\uff0c\u4e26\u63a2\u8a0e\u5176\u53ef\u884c\u6027\u3001\u5b89\u5168\u6027\u53ca\u6709\u6548\u6027\u3002<\/strong><\/span><\/p>\n

\"\"
\u5716\u7247\u4f86\u6e90: pixabay<\/figcaption><\/figure>\n

\u6587\uff0f\u9673\u6df5\u9293<\/strong><\/p>\n

\u25cf\u8207\u5de8\u7d30\u80de\u75c5\u6bd2\u611f\u67d3\u76f8\u95dc\u4e4b<\/strong>\u8166\u7624\u50b3\u7d71\u6cbb\u7642\u7b56\u7565<\/strong><\/span><\/p>\n

\u53ef\u7528\u65bc\u6cbb\u7642\u5de8\u7d30\u80de\u75c5\u6bd2\uff08cytomegalovirus, CMV\uff09\u6025\u6027\u611f\u67d3\uff08acute infection\uff09\u7684\u85e5\u7269\u96d6\u7136\u5f88\u591a\uff0c\u5982ganciclovir\u3001valganciclovir\u3001cidofovir \u548c foscarnet\u7b49\uff0c\u4e26\u5df2\u767c\u73fe\u4e00\u7a2e\u795e\u7d93\u6d3b\u6027\u7684\u60c5\u7dd2\u7a69\u5b9a\u5291valnoctamide\uff0c\u53ef\u6291\u5236\u5927\u8166\u548c\u5927\u8166\u767c\u80b2\u904e\u7a0b\u4e2d\u7684CMV\u611f\u67d3\uff0c\u4ee5\u6e1b\u8f15\u795e\u7d93\u884c\u70ba\u529f\u80fd\u969c\u7919\uff0c\u88ab\u8b49\u660e\u5177\u6709\u5c0d\u6297CMV\u7684\u6f5b\u529b\uff0c\u4f46\u662f\u53ef\u6709\u6548\u7528\u65bc\u6cbb\u7642\u8166\u7624\u8005\u537b\u5f88\u5c11\u3002\u76ee\u524d\u8166\u7624\u60a3\u8005\u7684\u6cbb\u7642\u65b9\u6cd5\u4e3b\u8981\u662f\u624b\u8853\u5207\u9664\u3001\u9ad8\u5291\u91cf\u653e\u5c04\u6cbb\u7642\u548c\u5316\u5b78\u7642\u6cd5\uff0c\u4f46\u6548\u679c\u6709\u9650\u4e14\u9810\u5f8c\uff08prognosis\uff09\u901a\u5e38\u4e0d\u4f73\uff0c\u60a3\u8005\u5f88\u5c11\u80fd\u5728\u78ba\u8a3a\u5f8c\u5b58\u6d3b\u8d85\u904e5\u5e74\u3002\u76ee\u524d\u8166\u7624\uff0d\u81a0\u8cea\u6bcd\u7d30\u80de\u7624\uff08glioblastoma, GBM\uff09\u7684\u6a19\u6e96\u6cbb\u7642\u6cd5\uff08standard therapy\uff09\u662f\u7d50\u5408\u5316\u5b78\u6cbb\u7642\uff08\u5982\u66ff\u83ab\u5511\u80fatemolozomide\uff09\u548c\u653e\u5c04\u6cbb\u7642\uff0c\u4f46\u53ea\u6709\u6975\u5c11\u6578\u60a3\u8005\u80fd\u5728\u6cbb\u7642\u5f8c\u5b58\u6d3b\u8d85\u904e5\u5e74\u3002\u7531\u65bc\u6a19\u6e96\u6cbb\u7642\u7121\u6cd5\u986f\u8457\u6539\u5584GBM\u81e8\u5e8a\u7642\u6548\uff0c\u56e0\u6b64\u9700\u8981\u958b\u767c\u66f4\u5b89\u5168\u3001\u6709\u6548\u7684\u6cbb\u7642\u7b56\u7565\uff0c\u4f8b\u5982\u514d\u75ab\u6cbb\u7642\u3002<\/p>\n

\u25cf\u8207\u5de8\u7d30\u80de\u75c5\u6bd2\u611f\u67d3\u76f8\u95dc\u4e4b\u8166\u7624\u514d\u75ab\u6cbb\u7642\u958b\u767c<\/strong><\/span><\/p>\n

\u6211\u5011\u5f9e\u5df2\u767c\u8868\u7684\u6587\u737b\u53ef\u77e5\u67d0\u4e9b\u60e1\u6027GBM\u6703\u8868\u9054CMV\u76f8\u95dc\u86cb\u767d\uff0c\u5305\u62ec\u7acb\u5373\u65e9\u671f\u7684\u57fa\u56e01\uff08immediately early gene-1, IE-1\uff09\u7522\u7269\u548cUL83\uff08unique long 83\uff09\u57fa\u56e0\u8868\u73fe\u7684\u4e0b\u57fa\u8cea\u78f7\u86cb\u767d65\uff08lower matrix phosphoprotein 65, pp65\uff09\uff0c\u986f\u73feCMV\u53ef\u80fd\u5728GBM\u7684\u767c\u751f\u4e0a\u626e\u6f14\u4e86\u95dc\u9375\u7684\u89d2\u8272\uff0c\u56e0\u70ba\u514d\u75ab\u7642\u6cd5\u53ef\u4fc3\u9032\u5bbf\u4e3b\u7684\u514d\u75ab\u7cfb\u7d71\u7684\u6fc0\u6d3b\u800c\u6709\u52a9\u65bc\u6291\u5236\u816b\u7624\u7d30\u80de\uff0c\u6240\u4ee5CMV\u53ef\u6210\u70ba\u5c0d\u6297GBM\u7684\u514d\u75ab\u6cbb\u7642\u7684\u9776\u6a19\uff08target\uff09\u3002<\/p>\n

\u57282014\u5e74\uff0c\u7f8e\u570b\u79d1\u5b78\u5bb6Nair\u7b49\u4eba\u5728\u9ad4\u5916\uff08in vitro\uff09\u7684\u5be6\u9a57\u4e2d\uff0c\u4f7f\u7528CMV pp65 RNA\u8f49\u67d3\uff08transfection\uff09\u7684\u6a39\u7a81\u72c0\u7d30\u80de\uff08dendritic cell, DC\uff09\u523a\u6fc0T\u7d30\u80de\uff0c\u85c9\u7531\u7279\u7570\u6027\u7684\u514d\u75ab\u53cd\u61c9\u6210\u529f\u7684\u53bb\u9664\u81ea\u9ad4\uff08autologous\uff09GBM\u7d30\u80de\u3002\u672c\u7814\u7a76\u7684\u81ea\u9ad4DC\u53caGBM\u7d30\u80de\u90fd\u662f\u5f9eGBM\u7684\u60a3\u8005\u9ad4\u5167\u5206\u96e2\u51fa\u4f86\u7684\uff0cCMV pp65\u7279\u7570\u6027\u514d\u75ab\u53cd\u61c9\u662f\u4f7f\u7528RNA\u8108\u885d\uff08pulse\uff09\u523a\u6fc0\u81ea\u9ad4DC\u8a98\u5c0e\u7522\u751f\u51fa\u4f86\u7684\uff0cCMV pp65\u7279\u7570\u6027\u7684T\u7d30\u80de\u4ee5\u5c08\u4e00\u6027\u7684\u65b9\u5f0f\u88c2\u89e3\u81ea\u9ad4\u548c\u539f\u767c\u6027GBM\u7d30\u80de\u3002\u4ed6\u5011\u4f7f\u7528RNA\u8108\u885d\u523a\u6fc0DC\u5728\u9ad4\u5916\u64f4\u589eT\u7d30\u80de\uff0c\u767c\u73feCMV pp65\u7279\u7570\u6027\u7684T\u7d30\u80de\u589e\u52a0\u4e8610\u523020\u500d\uff0c\u4e26\u6709\u6548\u7834\u58de\u4e86\u8868\u73feCMV pp65\u7684GBM\u7d30\u80de\uff0c\u7d50\u679c\u8868\u660eCMV pp65\u7279\u7570\u6027\u7684T\u7d30\u80de\u53ef\u5728\u9ad4\u5916\u6709\u6548\u5730\u6bba\u6b7bGBM\u7d30\u80de\u3002\u672c\u7814\u7a76\u986f\u793a\u514d\u75ab\u6cbb\u7642\u5177\u6709\u6f5b\u529b\u5728\u5c0dGBM\u5468\u570d\u6b63\u5e38\u7d30\u80de\u548c\u5065\u5eb7\u7d44\u7e54\u7d30\u80de\u640d\u5bb3\u6700\u5c0f\u7684\u60c5\u6cc1\u4e0b\uff0c\u5728\u60a3\u8005\u9ad4\u5167\u8a98\u5c0e\u7522\u751f\u5c0d\u6297GBM\u7684\u514d\u75ab\u53cd\u61c9\uff0c\u4e26\u652f\u6301\u8207CMV\u6709\u95dc\u7684GBM\u514d\u75ab\u6cbb\u7642\u7684\u767c\u5c55\u3002<\/p>\n

\u57282017\u5e74\uff0c\u7f8e\u570b\u79d1\u5b78\u5bb6Batich\u7b49\u4eba\u8a55\u4f30\u5291\u91cf\u589e\u52a0\u7684\u66ff\u83ab\u5511\u80fa\uff08dose-intensified temozolomide, DI-TMZ\uff09\u8207CMV pp65-DC\u7d50\u5408\u5f8c\u7684\u7279\u7570\u6027\u7d30\u80de\u514d\u75ab\u53cd\u61c9\uff0c\u4e26\u78ba\u8a8d\u5c0dGBM\u60a3\u8005\u9577\u671f\u7121\u9032\u5c55\u5b58\u6d3b\u671f\uff08long-term progression-free survival, PFS\uff09\u548c\u6574\u9ad4\u5b58\u6d3b\u7387\uff08overall survival, OS\uff09\u7684\u5f71\u97ff\u3002\u5728\u9019\u500b\u96a8\u6a5f\u7684\u5148\u5c0e\u81e8\u5e8a\u8a66\u9a57\u4e2d\uff0c\u670911\u540dGBM\u4f34\u96a8CMV\u611f\u67d3\u7684\u60a3\u8005\u63a5\u53d7\u4e86DI-TMZ\u548c\u81f3\u5c11\u4e09\u5291\u75ab\u82d7\uff08\u5305\u542bCMV pp65\u6eb6\u9176\u9ad4\u76f8\u95dc\u819c\u7cd6\u86cb\u767dmRNA\u8108\u885d\u7684DC\u53ca\u4f7f\u7528\u9846\u7c92\u7403-\u5de8\u566c\u7d30\u80de\u96c6\u843d\u523a\u6fc0\u56e0\u5b50granulocyte-macrophage colony-stimulating factor\u4f5c\u70ba\u4f50\u5291\uff09\u63a5\u7a2e\u3002\u5728\u672c\u7814\u7a76\u4e2d\uff0c\u4ed6\u5011\u767c\u73fe\u60a3\u8005\u5c0d\u6297CMV pp65\u7684\u7d30\u80de\u514d\u75ab\u53cd\u61c9\u5728\u4f7f\u7528DI-TMZ\u548c\u63a5\u7a2e\u4e09\u5291\u75ab\u82d7\u5f8c\u986f\u8457\u589e\u52a0\uff0c\u8abf\u7bc0\u6027T\uff08Treg\uff09\u7d30\u80de\u7684\u6bd4\u4f8b\u548c\u589e\u6b96\u4ea6\u63d0\u9ad8\uff0c\u4e26\u5728\u96a8\u5f8c\u7684\u5468\u671f\u4e2d\u6301\u7e8c\u589e\u52a0\uff0c\u60a3\u8005\u7684PFS\u548cOS\u4e2d\u9593\u503c\uff08median\uff09\u5206\u5225\u8d85\u904e5\u5e74\u5b58\u6d3b\u671f25.3\u500b\u6708\u548c41.1\u500b\u6708\uff0c\u63a5\u53d7CMV pp65-DC\u7684\u60a3\u8005\u8868\u73fe\u51fa\u8f03\u9577\u7684PFS\u548cOS\u3002\u672c\u7814\u7a76\u63d0\u4f9b\u4e86GBM\u4e2dCMV pp65\u6a19\u9776\u75ab\u82d7\u63a5\u7a2e\u8207\u9577\u671f\u5b58\u6d3b\u7684\u76f8\u95dc\u6027\u4e4b\u81e8\u5e8a\u8b49\u64da\uff0c\u4e26\u8b49\u660eCMV pp65\u53ef\u4f5c\u70baGBM\u60a3\u8005\u514d\u75ab\u6cbb\u7642\u7684\u9776\u6a19\u3002<\/p>\n

\u57282017\u5e74\uff0c\u7f8e\u570b\u79d1\u5b78\u5bb6Lamano\u7b49\u4eba\u767c\u8868\u4e86\u4e00\u540d\u63a5\u53d7\u514d\u75ab\u6cbb\u7642\u7684GBM\u4f34\u96a8CMV\u611f\u67d3\u7684\u5a66\u5973\u7684\u81e8\u5e8a\u75c5\u4f8b\u5831\u544a\uff08case report\uff09\uff0c\u986f\u793a\u9019\u540d\u5a66\u5973\u5728\u88ab\u8a3a\u65b7\u70baGBM\u5f8c\u6301\u7e8c\u5b58\u6d3b\u4e867\u5e74\uff0c\u4e26\u5f9eCMV\u5927\u8178\u7d50\u8178\u708e\uff08colitis\uff09\u4e2d\u5eb7\u5fa9\u3002\u5728\u81e8\u5e8a\u6cbb\u7642\u904e\u7a0b\u4e2d\uff0c\u8a72\u5a66\u5973\u5207\u9664GBM\u5f8c\uff0c\u7e7c\u7e8c\u63a5\u53d7\u653e\u5c04\u6cbb\u7642\u548ctemolozomide\u806f\u5408\u6cbb\u7642\uff0c\u4f46\u4f75\u767c\u4e86CMV\u5927\u8178\u7d50\u8178\u708e\u548c\u8179\u90e8\u81bf\u816b\uff08abdominal abscess\uff09\u3002\u60a3\u8005\u672a\u63a5\u53d7temolozomide\u8f14\u52a9\u6cbb\u7642\uff0c\u5728\u5207\u9664\u653e\u5c04\u7dda\u58de\u6b7b\u7d44\u7e54\u524d\u4ecd\u67095\u5e74\u7684PFS\uff0c\u4f46\u662f\u9019\u500b\u5a66\u5973\u518d\u6b21\u5207\u9664\u58de\u6b7b\u7d44\u7e54\u5f8c\u53c8\u7e7c\u7e8c\u5b58\u6d3b\u4e862\u5e74\u3002\u7531\u65bc\u60a3\u8005\u7684\u816b\u7624\u5c0dCMV IE-1\u548cpp65\u6297\u539f\u5448\u73fe\u967d\u6027\u53cd\u61c9\uff0c\u6240\u4ee5\u4ed6\u5011\u5047\u8a2d\u60a3\u8005\u5728\u6062\u5fa9\u904e\u7a0b\u4e2d\u7522\u751f\u4e86\u91dd\u5c0dCMV\u7684\u514d\u75ab\u53cd\u61c9\uff0c\u56e0\u800c\u6709\u52a9\u65bc\u624b\u8853\u5f8c\u76e3\u8996\u548c\u5ef6\u9577\u5b58\u6d3b\u671f\u3002\u9019\u500b\u75c5\u4f8b\u5831\u544a\u986f\u793a\uff0c\u60a3\u8005\u9808\u7522\u751f\u5c0d\u6297CMV\u6297\u539f\u7684\u514d\u75ab\u53cd\u61c9\u624d\u80fd\u9577\u671f\u5b58\u6d3b\uff0c\u4e26\u53ef\u652f\u6301GBM\u514d\u75ab\u7642\u6cd5\u7684\u53ef\u884c\u6027\u3001\u5b89\u5168\u6027\u53ca\u6709\u6548\u6027\u3002<\/p>\n

\u25cf\u7d50\u8ad6<\/strong><\/span><\/p>\n

\u76ee\u524dGBM\u7684\u6a19\u6e96\u6cbb\u7642\u65b9\u6cd5\u5305\u62ec\u9032\u884c\u624b\u8853\u5207\u9664\uff0c\u518d\u9032\u884c\u5316\u5b78\u53ca\u653e\u5c04\u7684\u806f\u5408\u6cbb\u7642\uff0c\u4f46\u9810\u5f8c\u901a\u5e38\u5f88\u5dee\uff0c\u5118\u7ba1\u5df2\u9032\u884c\u4e86\u5ee3\u6cdb\u7684\u7814\u7a76\uff0c\u4f46\u5728\u60a3\u8005\u7684\u9577\u671f\u751f\u5b58\u4e2d\u4ecd\u50c5\u53d6\u5f97\u5f88\u5c11\u7684\u6548\u679c\u3002GBM\u7684\u514d\u75ab\u7642\u6cd5\u662f\u8fd1\u4f86\u88ab\u6df1\u5165\u63a2\u8a0e\u7684\u9818\u57df\uff0c\u65b0\u578b\u514d\u75ab\u6cbb\u7642\u96d6\u5df2\u5728\u67d0\u4e9b\u81e8\u5e8a\u6848\u4f8b\u4e2d\u61c9\u7528\uff0c\u4f46\u5c1a\u672a\u88ab\u7d0d\u5165\u6a19\u6e96\u6cbb\u7642\u65b9\u6cd5\u3002\u6211\u5011\u61c9\u8a72\u9032\u4e00\u6b65\u63a2\u8a0e\u4f7f\u7528CMV\u4f5c\u70ba\u6cbb\u7642GBM\u4e4b\u9776\u6a19\u7684\u539f\u7406\u548c\u53ef\u884c\u6027\uff0c\u4e26\u6df1\u5165\u7814\u7a76\u4f7f\u7528\u7279\u7570\u6027\u514d\u75ab\u6cbb\u7642\u5728\u5c0d\u6297GBM\u7684\u5b89\u5168\u6027\u548c\u6709\u6548\u6027\u3002<\/p>\n

 <\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n

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  1. Wang SC<\/a>, Chen SJ<\/a>, Chen YC<\/a>. Potential Therapeutic Approaches Against Brain Diseases Associated with Cytomegalovirus Infections.<\/a> Int J Mol Sci. 2020 Feb 18;21(4). pii: E1376. doi: 10.3390\/ijms21041376. Review.<\/li>\n
  2. Nair SK<\/a>, De Leon G<\/a>, Boczkowski D<\/a>, Schmittling R<\/a>, Xie W<\/a>, Staats J<\/a>, Liu R<\/a>, Johnson LA<\/a>, Weinhold K<\/a>, Archer GE<\/a>, Sampson JH<\/a>, Mitchell DA<\/a>. Recognition and killing of autologous, primary glioblastoma tumor cells by human cytomegalovirus pp65-speci\ufb01c cytotoxic T cells. Clin Cancer Res.<\/a>2014 May 15;20(10):2684-2694. doi: 10.1158\/1078-0432.CCR-13-3268. Epub 2014 Mar 21.<\/li>\n
  3. Batich KA<\/a>, Reap EA<\/a>, Archer GE<\/a>, Sanchez-Perez L<\/a>, Nair SK<\/a>, Schmittling RJ<\/a>, Norberg P<\/a>, Xie W<\/a>, Herndon JE 2nd<\/a>, Healy P<\/a>, McLendon RE<\/a>, Friedman AH<\/a>, Friedman HS<\/a>, Bigner D<\/a>, Vlahovic G<\/a>, Mitchell DA<\/a>, Sampson JH<\/a>. Long-term survival in glioblastoma with cytomegalovirus pp65-targeted vaccination. Clin Cancer Res.<\/a>2017 Apr 15;23(8):1898-1909. doi: 10.1158\/1078-0432.CCR-16-2057.<\/li>\n
  4. Lamano JB<\/a>, Quaggin-Smith JA<\/a>, Horbinski CM<\/a>, Tate MC<\/a>, Grimm SA<\/a>, Kumthekar PU<\/a>, Bloch O<\/a>..Long-term glioblastoma survival following recovery from cytomegalovirus colitis: A case report. J Clin Neurosci.<\/a>2019 Jun;64:18-21. doi: 10.1016\/j.jocn.2019.03.051. Epub 2019 Apr 1.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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