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靶向CD47:癌症免疫治疗当前研究的成果与担忧

Targeting CD47: the achievements and concerns of current studies on cancer immunotherapy.

作者信息

Huang Yuting, Ma Yuchi, Gao Peng, Yao Zhi

机构信息

Department of Immunology, Tianjin Key Laboratory of Cellular and Molecular Immunology, Key Laboratory of Educational Ministry of China, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300071, China.

Center for Molecular Medicine, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.

出版信息

J Thorac Dis. 2017 Feb;9(2):E168-E174. doi: 10.21037/jtd.2017.02.30.

Abstract

Targeting CD47 is in the spotlight of cancer immunotherapy. Blocking CD47 triggers the recognition and elimination of cancer cells by the innate immunity. There are three CD47 antagonists in phase I clinical trials, but their potential efficacies are highly controversial. We raise our concern that NOD-based xenograft hosts tend to overestimate, while syngeneic mouse models could substantially underestimate the efficacy of anti-CD47 therapy. Such discrepancy may be resulted from specific reagent that alters CD47 clustering, and the highly variable avidities of interspecies and intraspecies CD47-SIRPα interaction. This problem can be addressed by alternative animal models for better recapitulation of human CD47-SIRPα interaction. Both fragment crystallizable (Fc) fragment-dependent effects, like antibody-dependent cell-mediated cytotoxicity (ADCC), and Fc-independent CD47 intrinsic functions are involved in anti-CD47 therapy. The latter may be SIRPα-dependent or SIRPα-independent, such as the case of calreticulin. It has not reached a consensus which of the factors predominate the process, but the answer to this question will determine the optimal pharmaceutical and clinical design of CD47 targeting strategies.

摘要

靶向CD47成为癌症免疫治疗的焦点。阻断CD47可触发先天免疫对癌细胞的识别与清除。有三种CD47拮抗剂正处于I期临床试验阶段,但其潜在疗效极具争议。我们担心基于非肥胖型糖尿病(NOD)的异种移植宿主往往会高估抗CD47疗法的疗效,而同种基因小鼠模型可能会大幅低估其疗效。这种差异可能源于改变CD47聚集的特定试剂,以及种间和种内CD47与信号调节蛋白α(SIRPα)相互作用的高度可变亲和力。这个问题可以通过替代动物模型来解决,以便更好地重现人类CD47-SIRPα相互作用。抗CD47治疗涉及可结晶片段(Fc)片段依赖性效应,如抗体依赖性细胞介导的细胞毒性(ADCC),以及Fc非依赖性CD47固有功能。后者可能依赖于SIRPα或不依赖于SIRPα,如钙网蛋白的情况。目前尚未就哪个因素在这一过程中起主导作用达成共识,但这个问题的答案将决定CD47靶向策略的最佳药物和临床设计。

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