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基于靶向调控脯氨酸内切酶枯草溶菌素 9 和免疫稳态对肝细胞癌的多种免疫调节策略。

Multiple Immunomodulatory Strategies Based on Targeted Regulation of Proprotein Convertase Subtilisin/Kexin Type 9 and Immune Homeostasis against Hepatocellular Carcinoma.

机构信息

Zhejiang Key Laboratory of Imaging and Interventional Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China.

Clinical College of The Affiliated Central Hospital, School of Medcine, Lishui University, Lishui 323000, China.

出版信息

ACS Nano. 2024 Mar 26;18(12):8811-8826. doi: 10.1021/acsnano.3c11775. Epub 2024 Mar 11.

Abstract

Immunotherapy is the most promising systemic therapy for hepatocellular carcinoma. However, the outcome remains poor. Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a role in altering cell-surface protein levels, potentially undermining the efficacy of immunotherapy against tumors. This highlights its potential as a target for antitumor therapy. Herein, CaCO-based nanoparticles coencapsulated with DOX, an immunogenic cell death (ICD) inducer, and evolocumab was developed to enhanced the efficacy of immunotherapy. The obtained DOX/evolocumab-loaded CaCO nanoparticle (named DECP) exhibits a good capacity of acid neutralization and causes ICD of cancer cells. In addition, DECP is able to evaluate the cell-surface level of MHC-I, a biomarker that correlates positively with patients' overall survival. Upon intravenous injection, DECP accumulates within the tumor site, leading to growth inhibition of hepa1-6 bearing subcutaneous tumors. Specifically, DECP treatment causes augmented ratios of matured dendritic cells, tumor-infiltrating CD8 T cells and natural killing cells, while concurrently depleting Foxp3 regulatory T cells. Peritumoral delivery of DECP enhances the immune response of distant tumors and exhibits antitumor effects when combined with intravenous αPD-L1 therapy in a bilateral tumor model. This study presents CaCO-based nanoparticles with multiple immunomodulatory strategies against hepatocellular carcinoma by targeting PCSK9 inhibition and modulating immune homeostasis in the unfavorable TME.

摘要

免疫疗法是治疗肝细胞癌最有前途的全身治疗方法。然而,其治疗效果仍然不佳。脯氨酸羧肽酶/丝氨酸羧肽酶 9(PCSK9)在改变细胞表面蛋白水平方面发挥作用,可能会削弱免疫疗法对肿瘤的疗效。这凸显了其作为抗肿瘤治疗靶点的潜力。在此,开发了基于 CaCO 的纳米粒子,共包封了 DOX(一种免疫原性细胞死亡(ICD)诱导剂)和依洛尤单抗,以增强免疫疗法的疗效。所得的载 DOX/依洛尤单抗的 CaCO 纳米颗粒(命名为 DECP)具有良好的中和酸的能力,并导致癌细胞发生 ICD。此外,DECP 能够评估 MHC-I 的细胞表面水平,MHC-I 是与患者总生存期呈正相关的生物标志物。静脉注射后,DECP 在肿瘤部位积聚,导致荷瘤皮下肿瘤的生长受到抑制。具体而言,DECP 治疗导致成熟树突状细胞、肿瘤浸润性 CD8 T 细胞和自然杀伤细胞的比例增加,同时耗竭 Foxp3 调节性 T 细胞。DECP 的瘤周给药增强了远处肿瘤的免疫反应,并在双侧肿瘤模型中与静脉注射αPD-L1 治疗联合使用时显示出抗肿瘤作用。本研究通过靶向 PCSK9 抑制和调节不利的 TME 中的免疫稳态,提出了针对肝细胞癌的具有多种免疫调节策略的基于 CaCO 的纳米粒子。

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