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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mimmun</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинская иммунология</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Immunology (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1563-0625</issn><issn pub-type="epub">2313-741X</issn><publisher><publisher-name>SPb RAACI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15789/1563-0625-NCT-3418</article-id><article-id custom-type="elpub" pub-id-type="custom">mimmun-3418</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Терапия NK-клетками при глиобластоме: от эксперементальных моделей к клиническим исследованиям</article-title><trans-title-group xml:lang="en"><trans-title>NK-cell therapy for glioblastoma: from experimental models to clinical trials</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-8752-8269</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Загородников</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zagorodnikov</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>лаборант-исследователь отдела по разработке и исследованиям в области иммунологии ООО «Текон Медицинские Приборы»</p></bio><bio xml:lang="en"><p>Research assistant of the Department for Development and Research in the field of Immunology of LLC “Tecon MP”.</p></bio><email xlink:type="simple">nikita.zagorodnikov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3881-3221</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абакушина</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Abakushina</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор медицинских наук; руководитель отдела по разработке и исследованиям в области иммунологии, заместитель генерального директора ООО «Текон Медицинские Приборы».</p></bio><bio xml:lang="en"><p>Doctor of Medical Sciences; Head of the Department for Development and Research in the field of Immunology, Deputy General Director of LLC “Tecon MP”</p></bio><email xlink:type="simple">abakushina@tecon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7627-5217</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Розенберг</surname><given-names>Ю. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Rosenberg</surname><given-names>J. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук; ведущий научный сотрудник отдела по разработке и исследованиям в области иммунологии ООО «Текон Медицинские Приборы».</p></bio><bio xml:lang="en"><p>PhD of Biological Sciences; Leading Researcher of the Department for Development and Research in the field of Immunology of LLC “Tecon MP”</p></bio><email xlink:type="simple">rosenbej@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ООО «Текон Медицинские Приборы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>LLC “Tecon MP”</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>19</day><month>08</month><year>2026</year></pub-date><volume>0</volume><issue>0</issue><issue-title>Online First</issue-title><elocation-id>3418</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Загородников Н.В., Абакушина Е.В., Розенберг Ю.М., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Загородников Н.В., Абакушина Е.В., Розенберг Ю.М.</copyright-holder><copyright-holder xml:lang="en">Zagorodnikov N.V., Abakushina E.V., Rosenberg J.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.mimmun.ru/mimmun/article/view/3418">https://www.mimmun.ru/mimmun/article/view/3418</self-uri><abstract><p>Глиобластома является наиболее агрессивной первичной опухолью мозга с крайне неблагоприятным прогнозом. Несмотря на стандартный протокол (хирургия, лучевая терапия и темозоломид), медиана общей выживаемости не превышает 16 месяцев, а рецидивы практически неизбежны. Иммунотерапия с использованием натуральных киллеров представляет собой перспективное направление благодаря способности этих клеток уничтожать опухолевые мишени без предварительной сенсибилизации и отсутствию риска реакции «трансплантат против хозяина» при аллогенном применении.</p><p>Цель обзора – систематизация и критический анализ современных данных о разработке терапии на основе NK-клеток и CAR-NK для лечения глиобластомы, а также выявление ключевых барьеров клинического применения.</p><p>В рамках исследования был проведен анализ публикаций баз PubMed и ClinicalTrials за последнее десятилетие, посвященных доклиническим исследованиям и клиническим испытаниям I-II фазы. Всего отобрано 25 доклинических и 10 клинических исследований.</p><p>В доклинических исследованиях наряду с иммортализованными клеточными линиями U87, U251 и 3D-сфероидными культурами стандартом стало использование ортотопических ксенографтов на иммунодефицитных мышах линии NSG с трансплантацией первичных глиомных стволовых клеток пациентов. Данная модель учитывает внутриопухолевую гетерогенность, микроокружение и вариабельность между разными пациентами. Наибольшую эффективность демонстрируют CAR-NK клетки, нацеленные на антигены GD2, CSPG4 и EGFRvIII, при локальном интратуморальном или интравентрикулярном введении.</p><p>Анализ 10 клинических исследований показал доминирование подходов с применением аллогенных NK-клеток и локальных способов введения. Среди завершённых исследований наилучший показатель медианы общей выживаемости 22,5 месяца достигнут при использовании аллогенных NK-клеток из периферической крови с многократными внутривенными инфузиями. В клинических протоколах применялись различные дозировки и схемы введения от однократных инъекций до многократных курсов, однако стандартизация режимов дозирования отсутствует.</p><p>Предварительные данные об эффективности терапии ограничены и требуют подтверждения в контролируемых исследованиях на большем объёме выборки пациентов. Выявлены три основных препятствия: проблема доставки через гематоэнцефалический барьер; иммуносупрессивное микроокружение глиобластомы (опосредованное TGF-β, лигандами NKG2A и PD-L1); отсутствие стандартизированных протоколов и доказательств эффективности III фазы. Рассмотрены стратегии преодоления барьеров, включающие генетическую инженерию клеток (CAR-конструкты, нокаут TGF-βR2 и NKG2A, экспрессия IL-15 для длительной персистенции), комбинацию с ингибиторами контрольных точек и таргетными препаратами.</p><p>В данном обзоре приведены рекомендации по оптимизации доклинического моделирования и планирования дальнейших клинических исследований для оценки потенциала NK-клеточной терапии с учётом комплексных инженерных подходов и локальной доставки.</p></abstract><trans-abstract xml:lang="en"><p>Glioblastoma is the most aggressive primary brain tumor with a dismal prognosis. Despite standard protocol (surgery, radiotherapy, temozolomide), median overall survival remains approximately 16 months, and relapse is almost inevitable. Immunotherapy based on Natural killer cells is a promising avenue due to their ability to eliminate tumor targets without prior sensitization and the lack of graft‑versus‑host disease risk when using allogeneic products.</p><p>The objective of this review is to systematize and critically analyze current data on the development NK‑cell and CAR‑NK‑based therapies for glioblastoma and to identify key barriers to clinical application.</p><p>The research includes the analysis of publications in PubMed and ClinicalTrials over the past decade, focusing on preclinical studies and phase I‑II clinical trials. A total of 25 preclinical and 10 clinical studies were included.</p><p>In preclinical studies, alongside immortalized lines U87, U251 and 3D spheroids, orthotopic xenografts in NSG mice with patient-derived glioma stem cells have become the standard. The model captures heterogeneity, microenvironment, and interpatient variability. CAR‑NK cells targeting GD2, CSPG4, and EGFRvIII show the highest efficacy with local intratumoral or intraventricular administration.</p><p>Clinical trials are dominated by allogeneic NK cells and local delivery. The best median overall survival of 22.5 months was achieved using allogeneic NK cells from peripheral blood with multiple intravenous infusions.</p><p>Preliminary data are limited and require confirmation in controlled trials. Three major obstacles were identified: the blood‑brain barrier; the immunosuppressive microenvironment (TGF‑β, NKG2A, PD‑L1); and the lack of standardized protocols and phase III evidence. Strategies to overcome these barriers include genetic engineering (CAR, TGF‑βR2/NKG2A knockout, IL‑15 expression), combination with checkpoint inhibitors, and targeted drugs.</p><p>Recommendations are provided for optimizing preclinical modeling and designing future clinical trials to assess the potential of NK‑cell therapy using integrated engineering approaches and local delivery.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>глиобластома</kwd><kwd>иммунотерапия</kwd><kwd>натуральные киллеры (NK-клетки)</kwd><kwd>CAR-NK</kwd><kwd>доклинические модели</kwd><kwd>ксенографты</kwd><kwd>клинические исследования</kwd><kwd>гематоэнцефалический барьер.</kwd></kwd-group><kwd-group xml:lang="en"><kwd>glioblastoma</kwd><kwd>immunotherapy</kwd><kwd>natural killer cells (NK cells)</kwd><kwd>CAR-NK</kwd><kwd>preclinical models</kwd><kwd>xenografts</kwd><kwd>clinical trials</kwd><kwd>blood-brain barrier.</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Воробьева И.Г., Абакушина Е.В. 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