Li Shenghao, Hao Liyuan, Zhang Junli, Deng Jiali, Hu Xiaoyu
Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-Er-Qiao Road, Chengdu, 610072, Sichuan Province, People's Republic of China.
Chengdu University of Traditional Chinese Medicine, No. 37 Shi-Er-Qiao Road, Chengdu, 610075, Sichuan Province, People's Republic of China.
Chin Med. 2023 Jun 24;18(1):76. doi: 10.1186/s13020-023-00785-x.
In chronic infections and cancers, T lymphocytes (T cells) are exposed to persistent antigen or inflammatory signals. The condition is often associated with a decline in T-cell function: a state called "exhaustion". T cell exhaustion is a state of T cell dysfunction characterized by increased expression of a series of inhibitory receptors (IRs), decreased effector function, and decreased cytokine secretion, accompanied by transcriptional and epigenetic changes and metabolic defects. The rise of immunotherapy, particularly the use of immune checkpoint inhibitors (ICIs), has dramatically changed the clinical treatment paradigm for patients. However, its low response rate, single target and high immunotoxicity limit its clinical application. The multiple immunomodulatory potential of traditional Chinese medicine (TCM) provides a new direction for improving the treatment of T cell exhaustion. Here, we review recent advances that have provided a clearer molecular understanding of T cell exhaustion, revealing the characteristics and causes of T cell exhaustion in persistent infections and cancers. In addition, this paper summarizes recent advances in improving T cell exhaustion in infectious diseases and cancer with the aim of providing a comprehensive and valuable source of information on TCM as an experimental study and their role in collaboration with ICIs therapy.
在慢性感染和癌症中，T淋巴细胞（T细胞）会持续接触抗原或炎症信号。这种情况通常与T细胞功能下降有关，即一种被称为“耗竭”的状态。T细胞耗竭是T细胞功能障碍的一种状态，其特征是一系列抑制性受体（IRs）表达增加、效应功能降低、细胞因子分泌减少，同时伴有转录和表观遗传变化以及代谢缺陷。免疫疗法的兴起，尤其是免疫检查点抑制剂（ICIs）的使用，极大地改变了患者的临床治疗模式。然而，其低反应率、单一靶点和高免疫毒性限制了其临床应用。中药的多种免疫调节潜力为改善T细胞耗竭的治疗提供了新方向。在此，我们回顾了近期取得的进展，这些进展使我们对T细胞耗竭有了更清晰的分子认识，揭示了持续性感染和癌症中T细胞耗竭的特征和原因。此外，本文总结了在改善传染病和癌症中T细胞耗竭方面的最新进展，旨在提供关于中药作为实验研究及其与ICIs疗法协同作用的全面且有价值的信息来源。
