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Tumor cells susceptible to oncolytic adenovirus infection refers to a specific physiological and genetic state of malignant cells that permits selective viral entry, replication, and subsequent lysis. This susceptibility is largely determined by the presence of high-affinity surface receptors, most notably the Coxsackievirus and Adenovirus Receptor (CAR) for serotype 5-based vectors, or CD46 and desmoglein-2 for other serotypes (Citations: PubMed: 9072970, 21149690). Beyond entry, the cell must have permissive intracellular conditions, such as a dysfunctional p53 or Rb pathway, which many oncolytic adenoviruses (e.g., H101, DNX-2401) are engineered to exploit for selective replication (Citations: PubMed: 8858120, 12659668). The therapeutic goal is to induce direct oncolysis while simultaneously stimulating a systemic anti-tumor immune response through the release of tumor antigens and danger signals. However, clinical application faces hurdles such as the rapid sequestration of adenovirus by the liver and the prevalence of pre-existing neutralizing antibodies in patients, which can significantly reduce the effective dose reaching the tumor (Citations: PubMed: 15660110).
Selective viral replication leading to direct oncolysis and the induction of systemic anti-tumor immunity.
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