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免疫检查点及其在癌症和传染病中的抑制作用。

Immune checkpoints and their inhibition in cancer and infectious diseases.

机构信息

Immune Regulation Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.

出版信息

Eur J Immunol. 2017 May;47(5):765-779. doi: 10.1002/eji.201646875. Epub 2017 Apr 24.

Abstract

The development of chronic infections and cancer is facilitated by a variety of immune subversion mechanisms, such as the production of anti-inflammatory cytokines, induction of regulatory T (Treg) cells, and expression of immune checkpoint molecules, including CTLA-4 and PD-1. CTLA-4, expressed on T cells, interacts with CD80/CD86, thereby limiting T-cell activation and leading to anergy. PD-1 is predominantly expressed on T cells and its interaction with PD-L1 and PD-L2 expressed on antigen-presenting cells (APCs) and tumors sends a negative signal to T cells, which can lead to T-cell exhaustion. Given their role in suppressing effector T-cell responses, immune checkpoints are being targeted for the treatment of cancer. Indeed, antibodies binding to CTLA-4, PD-1, or PD-L1 have shown remarkable efficacy, especially in combination therapies, for a number of cancers and have been licensed for the treatment of melanoma, nonsmall cell lung cancer, and renal and bladder cancers. Moreover, immune checkpoint inhibitors have been shown to enhance ex vivo effector T-cell responses from patients with chronic viral, bacterial, or parasitic infection, including HIV, tuberculosis, and malaria. Although the data from clinical trials in infectious diseases are still sparse, these inhibitors have great potential for treating chronic infections, especially when combined with therapeutic vaccines.

摘要

慢性感染和癌症的发展是由多种免疫颠覆机制促进的,如产生抗炎细胞因子、诱导调节性 T(Treg)细胞以及表达免疫检查点分子,包括 CTLA-4 和 PD-1。CTLA-4 表达于 T 细胞上,与 CD80/CD86 相互作用,从而限制 T 细胞的激活,导致无能。PD-1 主要表达于 T 细胞上,其与抗原呈递细胞(APCs)和肿瘤上表达的 PD-L1 和 PD-L2 的相互作用向 T 细胞发出负信号,可导致 T 细胞衰竭。鉴于它们在抑制效应 T 细胞反应中的作用,免疫检查点已成为癌症治疗的靶点。事实上,与 CTLA-4、PD-1 或 PD-L1 结合的抗体已显示出显著的疗效,尤其是在联合疗法中,对多种癌症有效,并已获准用于治疗黑色素瘤、非小细胞肺癌以及肾和膀胱癌。此外,免疫检查点抑制剂已被证明可增强慢性病毒、细菌或寄生虫感染(包括 HIV、结核病和疟疾)患者的体外效应 T 细胞反应。尽管传染病临床试验的数据仍然很少,但这些抑制剂在治疗慢性感染方面具有很大的潜力,尤其是与治疗性疫苗联合使用时。

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