Department of Respiratory Medicine, The Second Hospital of Jilin University, Changchun, China.
Hospital of Jilin University, Changchun, China.
J Transl Med. 2024 Jan 23;22(1):95. doi: 10.1186/s12967-024-04884-7.
Idiopathic pulmonary fibrosis (IPF) is a globally prevalent, progressive disease with limited treatment options and poor prognosis. Because of its irreversible disease progression, IPF affects the quality and length of life of patients and imposes a significant burden on their families and social healthcare services. The use of the antifibrotic drugs pirfenidone and nintedanib can slow the progression of the disease to some extent, but it does not have a reverse effect on the prognosis. The option of lung transplantion is also limited owing to contraindications to transplantation, possible complications after transplantation, and the risk of death. Therefore, the discovery of new, effective treatment methods is an urgent need. Over recent years, various studies have been undertaken to investigate the relationship between interstitial pneumonia and lung cancer, suggesting that some immune checkpoints in IPF are similar to those in tumors. Immune checkpoints are a class of immunosuppressive molecules that are essential for maintaining autoimmune tolerance and regulating the duration and magnitude of immune responses in peripheral tissues. They can prevent normal tissues from being damaged and destroyed by the immune response. While current studies have focused on PD-1/PD-L1 and CTLA-4, PD-1/PD-L1 may be the only effective immune checkpoint IPF treatment. This review discusses the application of PD-1/PD-L1 checkpoint in IPF, with the aim of finding a new direction for IPF treatment.
特发性肺纤维化(IPF)是一种全球普遍存在的进行性疾病,治疗选择有限,预后不良。由于其疾病进展不可逆转,IPF 会影响患者的生活质量和寿命,并给他们的家庭和社会医疗保健服务带来巨大负担。使用抗纤维化药物吡非尼酮和尼达尼布可以在一定程度上减缓疾病的进展,但对预后没有逆转作用。肺移植的选择也受到移植禁忌症、移植后可能出现的并发症和死亡风险的限制。因此,迫切需要发现新的、有效的治疗方法。近年来,各种研究已经在探讨间质性肺炎和肺癌之间的关系,表明 IPF 中的一些免疫检查点与肿瘤中的相似。免疫检查点是一类免疫抑制分子,对于维持自身免疫耐受和调节外周组织中免疫反应的持续时间和强度至关重要。它们可以防止免疫反应对正常组织造成损伤和破坏。虽然目前的研究主要集中在 PD-1/PD-L1 和 CTLA-4 上,但 PD-1/PD-L1 可能是治疗 IPF 的唯一有效免疫检查点。本综述讨论了 PD-1/PD-L1 检查点在 IPF 中的应用,旨在为 IPF 治疗寻找新的方向。