RESUMO
Cellular immunotherapy has revolutionized the oncology field, yielding improved results against hematological and solid malignancies. NK cells have become an attractive alternative due to their capacity to activate upon recognition of "stress" or "danger" signals independently of Major Histocompatibility Complex (MHC) engagement, thus making tumor cells a perfect target for NK cell-mediated cancer immunotherapy even as an allogeneic solution. While this allogeneic use is currently favored, the existence of a characterized memory function for NK cells ("memory-like" NK cells) advocates for an autologous approach, that would benefit from the allogeneic setting discoveries, but with added persistence and specificity. Still, both approaches struggle to exert a sustained and high anticancer effect in-vivo due to the immunosuppressive tumor micro-environment and the logistical challenges of cGMP production or clinical deployment. Novel approaches focused on the quality enhancement and the consistent large-scale production of highly activated therapeutic memory-like NK cells have yielded encouraging but still unconclusive results. This review provides an overview of NK biology as it relates to cancer immunotherapy and the challenge presented by solid tumors for therapeutic NKs. After contrasting the autologous and allogeneic NK approaches for solid cancer immunotherapy, this work will present the current scientific focus for the production of highly persistent and cytotoxic memory-like NK cells as well as the current issues with production methods as they apply to stress-sensitive immune cells. In conclusion, autologous NK cells for cancer immunotherapy appears to be a prime alternative for front line therapeutics but to be successful, it will be critical to establish comprehensives infrastructures allowing the production of extremely potent NK cells while constraining costs of production.
Assuntos
Imunoterapia , Neoplasias , Humanos , Neoplasias/terapia , Células Matadoras Naturais , Microambiente TumoralRESUMO
Chondro-epiphyseal separation of the distal humerus is a rare injury, and when it occurs in the newborn, it may be difficult to diagnose and is easily mistaken for a dislocation of the elbow. The unimpressive clinical appearance of such an injury of the elbow in an infant, as well as the absence of ossific nuclei of the distal humerus in the newborn, are responsible for the dilemma in making the diagnosis. Ultrasonography, a readily available, non-invasive technique, can be used to evaluate the non-ossified epiphysis about the elbow of infants to demonstrate dislocations, fractures, and physeal separations. Closed reduction with or without percutaneous Kirschner wire fixation is the treatment of choice for these injuries. In this article, we report on a case of complete epiphyseal separation in a neonate and discuss the problems arising in its diagnosis.
Assuntos
Traumatismos do Nascimento/diagnóstico , Cartilagem Articular/lesões , Lesões no Cotovelo , Epífises/lesões , Úmero , Traumatismos do Nascimento/cirurgia , Articulação do Cotovelo/cirurgia , Feminino , Humanos , Recém-Nascido , GravidezRESUMO
PIP: In this article the author criticizes the methodology and the findings of an article by Mauldin and Berelson which appeared in 1978 in Studies in Family Planning about population decrease in developing countries and about its implications on population policies. According to the author that article did not take into consideration: 1) the fact that socioeconomic conditions in a given country are more important than family planning programs for a decrease in fertility rate; 2) the fact that it is not known which kinds of family planning programs are more effective, and which kind of social level is more conducive to fertility decrease; and, 3) the status and educational level of women in the countries studied. In conclusion, the author states that the findings of Mauldin and Berelson, although interesting, imply arbitrary procedures and statistics, and cannot be used for the purpose of population policy.^ieng