Chengdu University of Traditional Chinese Medicine, No. 37 Shi-Er-Qiao Road, Chengdu, 610075, Sichuan Province, People's Republic of China.
Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-Er-Qiao Road, Chengdu, 610072, Sichuan Province, People's Republic of China.
J Cancer Res Clin Oncol. 2023 Oct;149(13):12543-12560. doi: 10.1007/s00432-023-05083-5. Epub 2023 Jul 9.
Liver cancer is one of the most common malignancies. T-cell exhaustion is associated with immunosuppression of tumor and chronic infection. Although immunotherapies that enhance the immune response by targeting programmed cell death-1(PD-1)/programmed cell death ligand 1 (PD-L1) have been applied to malignancies, these treatments have shown limited response rates. This suggested that additional inhibitory receptors (IRs) also contributed to T-cell exhaustion and tumor prognosis. Exhausted T-cells (Tex) in the tumor immune microenvironment (TME) are usually in a dysfunctional state of exhaustion, such as impaired activity and proliferative ability, increased apoptosis rate, and reduced production of effector cytokines. Tex cells participate in the negative regulation of tumor immunity mainly through IRs on the cell surface, changes in cytokines and immunomodulatory cell types, causing tumor immune escape. However, T-cell exhaustion is not irreversible and targeted immune checkpoint inhibitors (ICIs) can effectively reverse the exhaustion of T-cells and restore the anti-tumor immune response. Therefore, the research on the mechanism of T-cell exhaustion in liver cancer, aimed at maintaining or restoring the effector function of Tex cells, might provide a new method for the treatment of liver cancer. In this review, we summarized the basic characteristics of Tex cells (such as IRs and cytokines), discussed the mechanisms associated with T-cell exhaustion, and specifically discussed how these exhaustion characteristics were acquired and shaped by key factors within TME. Then new insights into the molecular mechanism of T-cell exhaustion suggested a potential way to improve the efficacy of cancer immunotherapy, namely to restore the effector function of Tex cells. In addition, we also reviewed the research progress of T-cell exhaustion in recent years and provided suggestions for further research.
肝癌是最常见的恶性肿瘤之一。T 细胞衰竭与肿瘤和慢性感染的免疫抑制有关。虽然针对程序性细胞死亡受体-1(PD-1)/程序性细胞死亡配体 1(PD-L1)的免疫疗法已被应用于恶性肿瘤,但这些治疗方法的反应率有限。这表明其他抑制性受体(IRs)也有助于 T 细胞衰竭和肿瘤预后。肿瘤免疫微环境(TME)中的衰竭 T 细胞(Tex)通常处于功能失调的衰竭状态,例如活性和增殖能力受损、凋亡率增加以及效应细胞因子产生减少。Tex 细胞主要通过细胞表面的 IRs、细胞因子和免疫调节细胞类型的变化参与肿瘤免疫的负调控,导致肿瘤免疫逃逸。然而,T 细胞衰竭不是不可逆的,靶向免疫检查点抑制剂(ICIs)可以有效地逆转 T 细胞的衰竭并恢复抗肿瘤免疫反应。因此,研究肝癌中 T 细胞衰竭的机制,旨在维持或恢复 Tex 细胞的效应功能,可能为肝癌的治疗提供新的方法。在这篇综述中,我们总结了 Tex 细胞的基本特征(如 IRs 和细胞因子),讨论了与 T 细胞衰竭相关的机制,并特别讨论了 TME 内的关键因素如何获得和塑造 Tex 细胞的衰竭特征。然后,对 T 细胞衰竭的分子机制的新见解提示了一种提高癌症免疫治疗疗效的潜在方法,即恢复 Tex 细胞的效应功能。此外,我们还回顾了近年来 T 细胞衰竭的研究进展,并为进一步研究提供了建议。
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