Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anatomy, School of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
Life Sci. 2022 Dec 1;310:121138. doi: 10.1016/j.lfs.2022.121138. Epub 2022 Oct 26.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment in the last decade. Among various checkpoints identified so far, interaction between programmed death-1 (PD-1) with programmed death ligand 1 (PD-L1) and their targeting using human monoclonal antibodies has attracted the most attention and is considered as the most prominent treatment with the best clinical outcomes. Accumulating evidence is the witness for the impact of gut microbiota on clinical responses and ICI efficacy. Specific bacterial species are identified in fecal specimens of cancer patients responding to the anti-PD-(L)1 immunotherapy, while non-responders demonstrate high abundance of other bacterial sources. Thus, the composition of gut microbiota may suggest potential biomarker in identification of patients with the best responses to immunotherapy. Notably, fecal microbial transplantation (FMT) from responders to non-responders has shown hopeful results in improving clinical outcomes and overcoming resistance to ICIs. Additionally, some bacterial components, such as the use of antibiotics and probiotic supplements have been shown to affect the efficacy of ICIs treatment. However, employment of these findings requires further investigations and precise understanding of the impact of gut microbiota on the host's immune responses. In the current review, we aim to discuss the roles of PD-1/PD-L1 checkpoint pathway, their therapeutic significance, and the impact of gut microbiota/products on the PD-1/PD-L1 immunotherapy outcomes.
免疫检查点抑制剂 (ICIs) 在过去十年中彻底改变了癌症治疗。在迄今为止发现的各种检查点中,程序性死亡受体 1 (PD-1) 与程序性死亡配体 1 (PD-L1) 之间的相互作用及其使用人源单克隆抗体进行靶向治疗引起了最多的关注,并被认为是最突出的治疗方法,具有最佳的临床结果。越来越多的证据表明肠道微生物群对临床反应和 ICI 疗效有影响。在对抗 PD-(L)1 免疫疗法有反应的癌症患者的粪便标本中鉴定出了特定的细菌种类,而无反应者则表现出其他细菌来源的丰度较高。因此,肠道微生物群的组成可能提示了潜在的生物标志物,用于识别对免疫疗法反应最佳的患者。值得注意的是,从有反应者向无反应者进行粪便微生物移植 (FMT) 已显示出改善临床结果和克服对 ICI 耐药性的有希望的结果。此外,一些细菌成分,如使用抗生素和益生菌补充剂,已被证明会影响 ICI 治疗的疗效。然而,这些发现的应用需要进一步的调查和对肠道微生物群对宿主免疫反应的影响的精确理解。在当前的综述中,我们旨在讨论 PD-1/PD-L1 检查点途径的作用、它们的治疗意义以及肠道微生物群/产物对 PD-1/PD-L1 免疫治疗结果的影响。