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NKG2D CAR NK cells are a class of chimeric antigen receptor (CAR)-engineered natural killer (NK) cell therapies designed to target cells expressing NKG2D ligands. The CAR construct typically incorporates the extracellular domain of the human NKG2D receptor (a C-type lectin-like activating receptor) fused to intracellular signaling domains such as 4-1BB (TNFRSF9) and CD3ζ (CD247). This architecture enables the engineered NK cells to recognize and eliminate tumor cells that upregulate stress-induced ligands, including MHC class I polypeptide-related sequence A/B (MICA/B) and UL16-binding proteins (ULBPs), which are broadly expressed across various hematologic and solid malignancies but have limited expression on healthy tissues. As an "off-the-shelf" allogeneic therapy, NKG2D CAR NK cells offer potential advantages over CAR-T cells, including a lower risk of cytokine release syndrome (CRS) and neurotoxicity. Clinical development is most advanced in myeloid malignancies like acute myeloid leukemia (AML), with ongoing research exploring applications in solid tumors such as glioma and colorectal cancer.
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