免疫检查点抑制剂在慢性乙型肝炎中的研究进展

慢性乙型肝炎病毒(hepatitis B virus,HBV)感染仍是全球主要公共卫生问题之一。尽管目前已有预防性疫苗可有效预防新发HBV感染,但全球仍有约2.5亿慢性HBV感染者,其中每年约有100多万人死于HBV相关的慢性肝病,形势仍不容乐观。抗病毒药物(干扰素和核苷类似物等)可抑制病毒复制,降低乙肝相关并发症,但由于其存在耐药性难以达到临床终点。免疫检查点抑制剂作为逆转T细胞耗竭的重要策略,重建有效的功能T细胞反应将是治疗慢性乙肝患者一种有前景的免疫调节方法。本文总结了程序性死亡受体1/细胞程序性死亡-配体1(PD-1/PD-L1)、细胞毒性T淋巴细胞相关蛋白4(CTLA-4)、T细胞免疫球蛋白和ITIM结构域(TIGIT)、T细胞免疫球蛋白和粘蛋白域蛋白-3 (Tim-3)、淋巴细胞活化基因-3(lag-3)五种免疫检查点分子的抑制剂在慢性乙型肝炎中的重要研究进展。     

细胞毒T淋巴细胞抗原-4的研究进展

细胞毒T淋巴细胞抗原-4(CTLA-4)是激活的T细胞表达的一种膜蛋白,属免疫球蛋白超家族成员,它通过与B7分子的结合来阻止共刺激信号的传递,抑制抗原特异性T淋巴细胞的增殖活化,起到抑制免疫反应及诱导免疫耐受的作用。CTLA-4在自身免疫病、过敏性疾病、感染、肿瘤及抗移植排斥等领域具有广阔的应用前景。简要综述了CTLA-4的基因、分子结构,及其与T细胞应答的关系。     

肿瘤治疗中免疫检查点抑制剂相关的感染并发症

近年来,免疫检查点抑制剂(immune checkpoint inhibitors,ICI)作为肿瘤免疫治疗的重要方法之一受到了广泛关注.针对细胞毒性T淋巴细胞抗原4、程序性死亡受体1和程序性死亡配体1的ICI,其临床应用为黑色素瘤和其他肿瘤的治疗带来了希望.目前没有证据表明ICI会直接增加感染的风险,但因免疫功能上调...     

Tim-3在诱导免疫耐受中的研究进展

T细胞免疫球蛋白黏液素3(T cell immunoglobulin mucin 3,Tim-3)可表达于Th1细胞,还可表达在其他免疫细胞及非免疫细胞。Tim-3能抑制T细胞介导的免疫反应,诱导免疫耐受。其可与多种配体结合,并在多种疾病的发生、发展中发挥着重要的调控作用。就近年来Tim-3在免疫反应中的作用机制作一综述,以期进一步认识Tim-3在诱导免疫耐受中的作用和潜在的治疗价值。     

肿瘤免疫疗法中免疫检查点的研究进展

免疫检查点(immune chenkpoint)是存在于免疫系统中的抑制性信号通路,对外周组织中免疫反应强度、持续性予以调节,防止组织损伤,并在维持自身抗原耐受性的过程中发挥作用。T细胞识别、清除肿瘤的过程受到诸多信号通路、配体/受体的严密调控。免疫检查点疗法就是一类通过调节T细胞活性来提高抗肿瘤免疫反应的治疗方法。目前,通过抑制免疫检查点阻断信号以调节T细胞活性增强其抗肿瘤效应是肿瘤治疗热点,例如利用CTLA-4(cytotoxic T lymphocyte antigen4)、PD-1(programmed cell death1)、PD-L1(programmed cell death 1 ligand)的拮抗剂以及其它药物干扰免疫检查点,可直接刺激细胞毒性T细胞的活化进而启动抗肿瘤免疫,介导持续的肿瘤抑制过程。而联合使用免疫检查点阻断剂加强肿瘤抑制效果也在进行深入研究。免疫检查点信号通路的生物学机制目前获得诸多进展,本文就一些已应用于临床的免疫检查点及其它新型免疫检查点的研究进展加以综述。     

调节性T细胞与胶质瘤的免疫治疗

调节性T细胞（regulatory T cell,Treg）是一群具有抑制其它免疫细胞功能的起负性调控的细胞群. Treg细胞能抑制多种免疫细胞,如CD4+T和CD8+T淋巴细胞、NK细胞、B淋巴细胞以及树突状细胞的活化和增殖,是体内维持免疫系统稳定,防止出现自身免疫性疾病重要因素.最新研究表明,Treg细胞在肿瘤免疫逃逸中也发挥重要作用. 肿瘤细胞通过扩增或招募Treg细胞,抑制机体对肿瘤的免疫作用,由此可知,Treg细胞在肿瘤的发生和发展过程中发挥重要作用. 因此,抑制Treg细胞的活性和数量是包括胶质瘤在内的肿瘤免疫治疗有效的方式.     

传代人淋巴细胞免疫猪的免疫效果初探

目的用传代人淋巴细胞替代人T淋巴细胞进行猪的免疫,用于试制抗人T细胞猪免疫球蛋白(anti-human T lymphocyte porcine immunoglobulin,P-ATG)免疫猪血浆,并评价其免疫效果。方法大量培养传代人淋巴细胞至免疫所需浓度及数量,采用常规猪免疫程序进行2次基础免疫及1次加强免疫,获得免疫猪血浆,用E玫瑰花环形成抑制试验和淋巴细胞毒试验进行效价检测。结果 3批免疫猪血浆的E玫瑰花环形成抑制试验结果均达到1∶1 000(花环形成率均小于对照组平均花环形成率的75%),淋巴细胞毒试验结果均达到1∶500(淋巴细胞死亡率均大于20%),效价均达到《中华人民共和国药典》2015版(三部)中生产用免疫猪血浆的效价标准。结论传代人淋巴细胞可作为人T淋巴细胞的替代免疫原进行猪的免疫,获得了效价合格的免疫猪血浆,用于P-ATG的制备。     

抑制性受体TIGIT在慢性病毒感染中的作用机制研究进展

T细胞免疫球蛋白和免疫受体酪氨酸抑制性基序结构域[T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif(ITIM) domain,TIGIT]是新型T细胞或NK细胞抑制性受体,可通过与肿瘤细胞、被感染细胞表面的多种配体相结合,激活免疫细胞内部负性刺激信号,从而抑制细胞过度活化和促炎性细胞因子的过度分泌,在肿瘤、病毒感染以及多种自身免疫病的免疫发病机制中发挥重要的调节功能。阐明TIGIT在免疫应答中的机制将有助于揭示多种疾病免疫应答中的T细胞功能低下,为多种疾病的治疗提供新的思路和靶点。我们就TIGIT在慢性病毒感染中的作用机制的最新研究进展做简要综述。     

以T细胞受体为基础的免疫疗法研究进展

T细胞是机体抗肿瘤免疫的核心,以T细胞功能调控为基础的免疫检查点疗法已经在多种肿瘤的临床治疗中取得了重大突破,以基因工程化T细胞为基础的过继性免疫细胞疗法在血液瘤治疗中取得了重要进展,免疫治疗已经对肿瘤的临床治疗产生了深刻变革,成为肿瘤临床治疗策略的重要组成部分。T细胞受体（T cell receptor,TCR）赋予了T细胞识别肿瘤抗原的特异性,能够识别由主要组织相容性复合体（major histocompatibility complex,MHC）呈递的包括胞内抗原在内的广泛肿瘤抗原,具有高度的抗原敏感性,因而具有广泛的抗肿瘤应用前景。2022年第一款TCR药物的上市开启了TCR药物开发的新纪元,多项TCR药物临床研究表现出潜在的肿瘤治疗价值。本文综述了以TCR为基础的免疫治疗策略研究进展,包括T细胞受体工程化T细胞（T cell receptor-engineered T cell,TCR-T）和TCR蛋白药物,以及基于TCR信号的其他免疫细胞疗法,以期为以TCR为基础的免疫治疗策略开发提供参考。     

T细胞抗原识别与活化研究

T细胞是通过其表面受体-T细胞抗原特异性受体（T cell antigen specific receptor,TCR）识别抗原并进行免疫应答的．T细胞如何识别以及清除抗原一直是分子免疫学研究的重点．免疫应答的重要过程是淋巴细胞的活化．而T细胞活化是细胞介导的免疫应答中不可缺少的内容．鉴于T细胞抗原识别和活化在免疫应答中的重要性．对近年来T细胞在抗原识别与活化研究方面所取得的重要进展进行了综述,并展望了T细胞的研究前景．     

Characterization of hepatitis B virus (HBV)-specific T-cell dysfunction in chronic HBV infection

Dysfunctional CD8+ T cells present in chronic virus infections can express programmed death 1 (PD-1) molecules, and the inhibition of the engagement of PD-1 with its ligand (PD-L1) has been reported to enhance the antiviral function of these T cells. We took advantage of the wide fluctuations in levels of viremia which are typical of chronic hepatitis B virus (HBV) infection to comprehensively analyze the impact of prolonged exposure to different virus quantities on virus-specific T-cell dysfunction and on its reversibility through the blocking of the PD-1/PD-L1 pathway. We confirm that chronic HBV infection has a profound effect on the HBV-specific T-cell repertoire. Despite the use of a comprehensive panel of peptides covering all HBV proteins, HBV-specific T cells were rarely observed directly ex vivo in samples from patients with chronic infection, in contrast to those from patients with acute HBV infection. In chronic HBV infection, virus-specific T cells were detected mainly in patients with lower levels of viremia. These HBV-specific CD8+ T cells expressed PD-1, and their function was improved by the blocking of PD-1/PD-L1 engagement. Thus, a broad spectrum of anti-HBV immunity is expressed by patients with chronic HBV infection and this spectrum is proportional to HBV replication levels and can be improved by blocking the PD-1/PD-L1 pathway. This information may be useful for the design of immunotherapeutic strategies to complement and optimize available antiviral therapies.     

Soluble CD40 ligand-activated B cells from patients with chronic hepatitis B virus infection as antigen presenting cells to induce hepatitis B virus specific cytotoxic T lymphocytes

Chronic hepatitis B virus (HBV) infection is the result of an inadequate antiviral immune response to the virus. In this study, we aimed to investigate whether the soluble CD40 ligand-activated B (CD40-B) cells could present antigen and induce specific cytotoxic T lymphocytes (CTLs) in patients with chronic HBV infection. We observed that after activated by sCD40L, the expression of CD80, CD86, major histocompatibility complex (MHC) I and II molecules on the CD40-B cells was significantly increased. Cytometry and fluorescence microscopy showed that more than 41.34% CD40-B cells were loaded by the HBcAg peptide. Furthermore, after been activated and HBcAg18–27 antigen peptide pulsed, B cells obtained from patients with chronic HBV infection could induce HBcAg18–27 specific CTLs in vitro. Taken together, our results show that B cells from patients with chronic HBV infection can be activated by sCD40L and may function as antigen presenting cells and induce HBV-specific CTLs.     

Fighting with the enemy's weapons? the role of costimulatory molecules in HIV

HIV infection is characterized by a number of abnormalities in several components of the immune system. For example, during HIV infection, a massive decrease of CD4(+) T cells is observed, as well as a progressive depletion of na?ve CD8(+) T cells. Furthermore, elevated numbers of apoptotic B and T cells are present in HIV-infected patients, and a systemic immune activation results in T-cell exhaustion. Finally, HIV infection is characterized by the presence of functionally impaired dendritic cells, with decreased expression of maturation markers, decreased secretion of cytokines and defects in antigen processing and presentation. All these characteristics result in the occurrence of non-functional cytotoxic T lymphocytes, that fail to control HIV-replication in most individuals during progressive disease. Costimulatory and co-inhibitory molecules are involved in the activation, differentiation and survival of several cell-types of the immune system. Each costimulatory receptor (generally expressed on effector cells) can conjugate with one or more specific ligands (expressed on antigen-presenting cells), which leads to an activation of intracellular signaling pathways inside the cells on which they are expressed. HIV infection is characterized by an aberrant expression of these molecules on cells of the immune system. Many of the immune deficiencies mentioned in the previous paragraph can be explained by abnormal expression of costimulatory molecules, and could consequently be overcome by interfering with their interactions. In this review, we give an overview of the functions and expression patterns of the receptor/ligand pairs of the tumor necrosis factor and the B7 super-families of costimulatory and co-inhibitory molecules in HIV-infected patients. We will also discuss possibilities for manipulating their signaling as a therapeutic anti-HIV tool.     

Immune complexes containing human immunodeficiency virus type 1 primary isolates bind to lymphoid tissue B lymphocytes and are infectious for T lymphocytes

This study investigated the interaction of tonsil B lymphocytes with immune complexes containing human immunodeficiency virus (HIV IC) primary isolates and the infectivity of the B cell-bound HIV IC. Treatment of virus with a source of antibody and complement increased HIV IC binding to B cells by 5.6-fold. Most of the HIV IC that bound to B cells were not internalized but remained on the cell surface and were gradually released over 72 h. Cell-bound HIV IC were highly infectious for T cells while virus released by cultured B cells was only slightly infectious. Removal of HIV IC from the B-cell surface by protease treatment reduced the infection of T cells to near-background levels, indicating that infectious virus remained on the B-cell surface. These studies show that B lymphocytes can carry and transfer infectious HIV IC to T cells and thus suggest a novel mode of infection of T cells in lymphoid tissue that could be important for pathogenesis during HIV infection.     

Combination of an antiviral drug and immunomodulation against hepadnaviral infection in the woodchuck model

The essential role of multispecific immune responses for the control of hepatitis B virus (HBV) infection implies the need of multimodal therapeutic strategies for chronic HBV infection, including antiviral chemotherapy and immunomodulation. This hypothesis was tested in the woodchuck model by a combination of lamivudine pretreatment and subsequent immunizations of woodchucks chronically infected with woodchuck hepatitis virus. The immunizations were performed with DNA vaccines or antigen-antibody immune complexes (IC)/DNA vaccines. Immunizations with IC/DNA vaccines led to an anti-woodchuck hepatitis virus surface antibody response and significant reductions of viral load and antigenemia, suggesting that such a strategy may be effective against chronic HBV infection.     

免疫应答——乙型肝炎病毒治疗中的双刃剑

人体对乙型肝炎病毒(hepatitis B virus,HBV)感染的免疫应答是一个非常复杂的病理过程,一方面免疫反应能有效清除HBV病毒和被病毒感染的肝细胞,对HBV诱发的肝类疾病有较好的治疗作用;另一方面,免疫反应在清除被感染肝细胞的同时,也引起局部炎症反应,从而损伤正常的肝细胞和组织.其中,特异性免疫T细胞及其产生的细胞因子是这一免疫应答过程的重要参与者.侧重总结了在HBV感染治疗中的关键细胞和分子及激活人体免疫应答治疗中的两面性,为调节自身免疫应答治疗HBV,避免应答不当而引发的肝损伤提供理论基础.     

Hepatitis B virus-induced lipid alterations contribute to natural killer T cell-dependent protective immunity

In most adult humans, hepatitis B is a self-limiting disease leading to life-long protective immunity, which is the consequence of a robust adaptive immune response occurring weeks after hepatitis B virus (HBV) infection. Notably, HBV-specific T cells can be detected shortly after infection, but the mechanisms underlying this early immune priming and its consequences for subsequent control of viral replication are poorly understood. Using primary human and mouse hepatocytes and mouse models of transgenic and adenoviral HBV expression, we show that HBV-expressing hepatocytes produce endoplasmic reticulum (ER)-associated endogenous antigenic lipids including lysophospholipids that are generated by HBV-induced secretory phospholipases and that lead to activation of natural killer T (NKT) cells. The absence of NKT cells or CD1d or a defect in ER-associated transfer of lipids onto CD1d results in diminished HBV-specific T and B cell responses and delayed viral control in mice. NKT cells may therefore contribute to control of HBV infection through sensing of HBV-induced modified self-lipids.     

Herpes simplex inhibits the capacity of lymphoblastoid B cell lines to stimulate CD4+ T cells

HSV establish a lifelong persistent infection in their host even among immunocompetent persons. The viruses use a variety of immune evasion strategies, presumably to assist persistent replication in the human host. We have observed that infection of human B lymphoblastoid cells (B-LCL) by HSV resulted in a strong inhibition of their ability to induce CD4(+) T cell clone proliferation and cytokine secretion. This inhibitory effect occurs in a variety of both HSV- and HIV-specific clones from three different patients. The inhibition is observed when the Ag is provided either as a soluble protein or as a synthetic peptide and is not associated with detectable down-modulation of the MHC class II molecules or costimulatory molecules. Expression of the HSV-1 unique sequence 1 gene (US1) is necessary and sufficient to induce this inhibition of APC function. US1 gene expression also made B-LCL less susceptible to CD4(+) T cell-mediated lysis. These data indicate a novel immune evasion strategy by HSV-1 in which Ag-processing cells that become infected by HSV-1 are inhibited in their ability to induce subsequent CD4(+) T cell activation.     

γ/δ T细胞与丙型肝炎病毒、乙型肝炎病毒感染

病毒性肝炎的发病机制迄今尚未完全明确,诸多证据表明,乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)所致肝炎可能是肝脏细胞免疫防御反应病毒入侵的结果。γ/δT细胞是新近认识的一个T细胞亚群,是机体抵抗外来病原微生物入侵的重要天然免疫细胞之一。近年研究发现,肝内富含γ/δT细胞,而病毒性肝炎肝内γ/δT细胞数量显著增高。目前有关γ/δT细胞与肝炎病毒感染的研究主要集中在HCV感染领域,即γ/δT细胞通过分泌多种细胞因子抑制体内HCV的复制。目前,有关γ/δT细胞与HBV感染的报道甚为少见。慢性HBV感染体内可能导致γ/δT细胞免疫学功能异常,这可能是导致体内病毒性乙型肝炎慢性化的主要原因之一。