Abstract

The innate lymphocyte lineage natural killer (NK) is now the target of multiple clinical applications, although none has received an agreement from any regulatory agency yet. Transplant of naïve NK cells has not proven efficient enough in the vast majority of clinical trials. Hence, new protocols wish to improve their medical use by producing them from stem cells and/or modifying them by genetic engineering. These techniques have given interesting results but these improvements often hide that natural killers are mainly that: natural. We discuss here different ways to take advantage of NK physiology to improve their clinical activity without the need of additional modifications except for in vitro activation and expansion and allograft in patients. Some of these tactics include combination with monoclonal antibodies (mAb), drugs that change metabolism and engraftment of specific NK subsets with particular activity. Finally, we propose to use specific NK cell subsets found in certain patients that show increase activity against a specific disease, including the use of NK cells derived from patients.

Highlights

  • Innate lymphoid cells (ILCs) play a main role in immune-related disorders and are divided into three groups: ILC1s, ILC2s, and ILC3s [1]

  • Natural killer (NK) cells, which belongs to the ILC1 group, are bone marrow derived cytotoxic lymphocytes (CL) that are well-equipped for the destruction of target cells without the need for prior antigen stimulation

  • In vitro results using RTX and CD20+ tumor cells deerived from chronic lymphocyte leukemia (CLL) patients do not show any differences on NK cell-mediated antibody-dependent cell cytotoxicity (ADCC) between opsonizing targets or “arming” NK [6]

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Summary

Introduction

Innate lymphoid cells (ILCs) play a main role in immune-related disorders and are divided into three groups: ILC1s, ILC2s, and ILC3s [1]. Due to all these adverse points recent clinical approaches target in vitro expanded and activated NK cells and the use of allogeneic NK cells. Clinical-grade production of allogeneic NK cells is efficient [28] and NK cell–mediated therapy, including the use of in vitro expanded allogeneic NK cells, seems safe [11, 13, 28,29,30,31].

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