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癌症中检查点抑制剂的作用机制及使用原理

Mechanisms of action and rationale for the use of checkpoint inhibitors in cancer.

作者信息

Granier Clemence, De Guillebon Eleonore, Blanc Charlotte, Roussel Helene, Badoual Cecile, Colin Elia, Saldmann Antonin, Gey Alain, Oudard Stephane, Tartour Eric

机构信息

INSERM U970, Université Paris Descartes Sorbonne Paris-Cité, Paris, France.

Equipe Labellisée Ligue Contre le Cancer, Paris, France.

出版信息

ESMO Open. 2017 Jul 3;2(2):e000213. doi: 10.1136/esmoopen-2017-000213. eCollection 2017.

Abstract

The large family of costimulatory molecules plays a crucial role in regulation of the immune response. These molecules modulate TCR signalling via phosphorylation cascades. Some of the coinhibitory members of this family, such as PD-1 and CTLA-4, already constitute approved targets in cancer therapy and, since 2011, have opened a new area of antitumour immunotherapy. Many antibodies targeting other inhibitory receptors (Tim-3, VISTA, Lag-3 and so on) or activating costimulatory molecules (OX40, GITR and so on) are under evaluation. These antibodies have multiple mechanisms of action. At the cellular level, these antibodies restore the activation signalling pathway and reprogram T cell metabolism. Tumour cells become resistant to apoptosis when an intracellular PD-L1 signalling is blocked. CD8 T cells are considered to be the main effectors of the blockade of inhibitory receptors. Certain CD8 T cell subsets, such as non-hyperexhausted (CD28, T-bet, PD-1), follicular-like (CXCR-5) or resident memory CD8 T cells, are more prone to be reactivated by anti-PD-1/PD-L1 monoclonal antibody (mAb). In the future, the challenge will be to rationally combine drugs able to make the tumour microenvironment more permissive to immunotherapy in order to potentiate its clinical activity.

摘要

共刺激分子大家族在免疫反应调节中起关键作用。这些分子通过磷酸化级联反应调节TCR信号传导。该家族的一些共抑制成员,如PD-1和CTLA-4,已成为癌症治疗中的获批靶点,自2011年以来,开启了抗肿瘤免疫治疗的新领域。许多靶向其他抑制性受体(Tim-3、VISTA、Lag-3等)或激活共刺激分子(OX40、GITR等)的抗体正在评估中。这些抗体具有多种作用机制。在细胞水平上,这些抗体恢复激活信号通路并重新编程T细胞代谢。当细胞内PD-L1信号传导被阻断时,肿瘤细胞对凋亡产生抗性。CD8 T细胞被认为是抑制性受体阻断的主要效应细胞。某些CD8 T细胞亚群,如非过度耗竭(CD28、T-bet、PD-1)、滤泡样(CXCR-5)或驻留记忆CD8 T细胞,更容易被抗PD-1/PD-L1单克隆抗体(mAb)重新激活。未来的挑战将是合理组合能够使肿瘤微环境更有利于免疫治疗的药物,以增强其临床活性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af2e/5518304/faad03ab78e1/esmoopen-2017-000213f01.jpg

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