近年来,嵌合抗原受体T(chimeric antigen receptor T, CAR-T )细胞免疫疗法在血液恶性肿瘤的治疗中取得了重要进展,但在实体瘤方面的应用并不理想。本文对CAR-T 细胞的结构、杀伤功能进行了介绍,包括非经典免疫突触的形成、分泌细胞因子、分泌穿孔素和颗粒酶、Fas-FasL (factor associated suicide-Fas ligand)途径以及组成CAR结构成分的改变等杀伤肿瘤的主要机制, 比较三种CAR细胞的特点,结合CAR-T细胞治疗实体瘤的挑战,对CAR-T细胞在肿瘤免疫治疗领域未来的研究方向进行了分析。

In recent years, significant progress has been made in the field of chimeric antigen receptor T (CAR-T) cell immunotherapy for the treatment of hematologic malignancies, while its application in solid tumors has proven to be less than optimal. This article provides an introduction to the structure and function of CAR-T cells, encompassing key mechanisms underlying tumor cytotoxicity such as the formation of non-classical immune synapses, cytokine secretion, perforin and granzyme release, the Fas (factor-associated suicide)-FasL (Fas ligand) pathway, and alterations in the components constituting the CAR structure. The features of three CAR cell types are compared, and in light of the challenges associated with CAR-T cell therapy for solid tumors, the article analyzes future research directions for CAR-T cells in the field of cancer immunotherapy.