Drewniak-Świtalska Magda, Fortuna Paulina, Krzystek-Korpacka Małgorzata
Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Omics Research Center, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Pharmaceutics. 2025 May 28;17(6):713. doi: 10.3390/pharmaceutics17060713.
Checkpoint inhibitors are a modern therapeutic approach for treating various types of cancer, metabolic diseases, and chronic infections. The main goal of this therapy is to specifically unlock the immune system, allowing it to recognize and eliminate cancer cells or pathogens, primarily through the activation of T lymphocytes. Monoclonal antibodies used in the treatment of various cancers, such as pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy), carry several limitations, primarily due to their large molecular size. The main challenges include limited tissue penetration, long half-life in the body, and the risk of autoimmune responses. Compared to antibodies, small-molecule and peptide inhibitors offer significant advantages related to their molecular structure. These drugs demonstrate a better ability to penetrate hard-to-reach areas, such as the tumor microenvironments, can be administered orally, and often show lower immunogenicity. A new generation of drugs is PROTACs, which combine the ability to direct proteins to degradation with the action of checkpoint inhibitors, contributing to the elimination of proteins responsible for suppressing the immune response. This publication describes small-molecule inhibitors, peptide inhibitors, and PROTAC molecules targeting negative immune checkpoints-CTLA-4, PD-1, VISTA, TIM-3, BTLA-4, LAG-3, and TIGIT.
检查点抑制剂是一种用于治疗各种类型癌症、代谢疾病和慢性感染的现代治疗方法。这种疗法的主要目标是特异性地激活免疫系统,使其能够识别并消除癌细胞或病原体,主要是通过激活T淋巴细胞来实现。用于治疗各种癌症的单克隆抗体,如帕博利珠单抗(可瑞达)、纳武利尤单抗(欧狄沃)和伊匹木单抗(逸沃),存在一些局限性,主要是由于其分子量大。主要挑战包括组织穿透力有限、在体内半衰期长以及自身免疫反应风险。与抗体相比,小分子和肽类抑制剂因其分子结构具有显著优势。这些药物在穿透难以到达的区域(如肿瘤微环境)方面表现出更好的能力,可以口服给药,并且通常免疫原性较低。新一代药物是PROTACs,它将引导蛋白质降解的能力与检查点抑制剂的作用相结合,有助于消除负责抑制免疫反应的蛋白质。本出版物描述了针对负性免疫检查点CTLA-4、PD-1、VISTA、TIM-3、BTLA-4、LAG-3和TIGIT的小分子抑制剂、肽类抑制剂和PROTAC分子。
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