CD47与乳腺癌相关性的研究进展

乳腺癌的发生、发展与许多因素有关,其中免疫系统在其发生与发展过程中发挥重要作用。CD47是高表达于乳腺癌细胞表面的跨膜蛋白,其配体为凝血酶敏感蛋白-1(thrombospondin-1,TSP1)和信号调节蛋白α(signal-regulatory protein alpha,SIRPα),其中CD47/SIRPα信号通路可产生抑制性信号降低巨噬细胞的吞噬作用,产生免疫逃逸。在乳腺癌细胞中CD47表达上调,且高表达的CD47提示预后不良。采用抗CD47抗体可以阻断肿瘤细胞CD47/SIRPα通路介导的抑制吞噬作用,目前抗CD47单克隆抗体的免疫疗法正逐步走向临床试验。本文主要阐述CD47的结构、生理功能及其与肿瘤相关巨噬细胞的关系,并对CD47在乳腺癌中的表达及与预后的关系、在免疫治疗中的作用进行综述。     

CD24在恶性肿瘤中的生物学功能及作为抗肿瘤靶点的应用

分化簇24 (cluster of differentiation 24, CD24)是一种小分子量、高度糖基化的细胞膜上表达的蛋白质，通过糖基磷脂酰肌醇锚点与质膜相连。正常情况下，CD24主要在人体的免疫细胞上表达，但在70%以上的恶性肿瘤细胞包括肝癌、肺癌及膀胱癌等中也发现其过度表达。CD24往往通过参与介导肿瘤发生发展的相关信号转导通路调节肿瘤细胞的生长增殖、转移及侵袭，包括和配体P-选择素结合促进肿瘤细胞转移，通过激活Wnt信号通路和MAPK信号通路促进肿瘤生长增殖等。因此，利用靶向CD24的siRNA或抗体等阻断其与相关信号通路的联系，将会成为潜在的抗肿瘤治疗方案之一。目前，包括抗体治疗、基因治疗及免疫治疗等方式在内的多项以CD24为靶点的抗肿瘤治疗药物，正处于临床前研究阶段。最新研究显示，CD24可通过与巨噬细胞上的配体-唾液酸结合Ig样凝集素10 (sialic-acid-binding Ig-like lectin 10, Siglec-10)结合，释放抑制巨噬细胞对肿瘤细胞吞噬的“别吃我”信号，进而导致肿瘤细胞逃避免疫监视。利用靶向CD24的抗体或CD24受体融合蛋白...     

二甲双胍在肿瘤治疗中的机制研究进展

作为胰岛素增敏剂的降糖药物二甲双胍具有抗肿瘤的多种生物活性,它能够抑制肿瘤细胞的增殖、促进凋亡、增强肿瘤对化疗药物的敏感性、并且能逆转部分肿瘤细胞对化疗药物的耐药性、甚至还能抑制肿瘤新生血管的生成.这些生物功能的实现依赖于AMPK等相关的信号通路的活化,进而负向调控mTOR通路信号分子的表达,再通过转录因子的表达调控相关靶基因的表达.因此这些信号分子的活化或抑制就成为了新的抗肿瘤治疗的靶点.肿瘤干细胞也是近年来研究的一个热点,二甲双胍能直接杀伤某些肿瘤的干细胞,从而达到有效抑瘤的作用.但二甲双胍杀伤肿瘤干细胞的分子机制不明确.另外.二甲双胍联合激素药物治疗肿瘤,可以增加保守治疗的效果.虽然二甲双胍具有显著的抗肿瘤的多重功效,但其具体的分子机制尚未被清晰完整的阐明,有待进一步的研究和证实.     

姜黄素抗肿瘤的机制

姜黄素具有很显著的抗肿瘤作用。本文通过对几年来国内外对姜黄素抗肿瘤的研究进行总结,介绍了姜黄素的抗肿瘤机制。在分子水平上,肿瘤细胞摄取姜黄素,增加药物作用的靶位点,调节肿瘤细胞的信号传递,从而调节肿瘤细胞中某些酶活性及蛋白质、基因的表达。在细胞水平上,姜黄素能抑制肿瘤细胞的增殖、促进肿瘤细胞凋亡、逆转肿瘤细胞的多药耐药性、增强NK细胞杀伤力。在组织水平上抑制肿瘤血管生成等方面来发挥抗肿瘤作用。     

注射紫杉醇的小鼠骨髓细胞体外分化巨噬细胞增强

目的研究小鼠腹腔注射紫杉醇对体外骨髓细胞诱导分化巨噬细胞的影响。方法小鼠连续5d腹腔注射紫杉醇,无菌制备骨髓细胞,用含巨噬细胞集落刺激因子（M-CSF）的RPMI1640培养液培养骨髓细胞,通过流式细胞仪对其诱导分化的巨噬细胞表面分子、吞噬功能进行分析。结果紫杉醇明显降低小鼠骨髓细胞数量,但骨髓细胞体外诱导分化成巨噬细胞的数量明显增加;F4/80^＋巨噬细胞中CD80、CD14表面分子表达升高,而I-A^d表达降低;紫杉醇处理组诱导分化的巨噬细胞吞噬鸡红细胞的能力提高。结论结果提示紫杉醇可能具有调节巨噬细胞表面分子的表达和吞噬功能。     

重组人过氧化物还原酶-5通过诱导巨噬细胞极化提高抗肿瘤免疫

肿瘤细胞能够采用不同的策略抑制人体免疫系统，使其不能正常杀伤肿瘤细胞。前期研究表明，重组人过氧化物还原酶-5 (human peroxiredoxin-5, hPRDX5)能够激活机体正常的抗肿瘤免疫反应，从而控制与清除肿瘤，然而，其确切的作用机制仍有待深入研究。本研究旨在探讨hPRDX5是否通过激活或者逆转小鼠巨噬细胞RAW264.7的极化状态，从而发挥其抗肿瘤活性。CCK8法检测结果显示，与对照组相比，不同剂量hPRDX5均能显著增强巨噬细胞活力(P<0.001);一氧化氮(nitric oxide, NO)检测试剂盒检测结果显示，hPRDX5显著增强RAW264.7细胞NO分泌水平(P<0.001);ELISA检测结果揭示，hPRDX5促进RAW264.7细胞TNF-α (P<0.01)和IL-6 (P<0.001)的分泌；流式细胞术结果揭示，hPRDX5能够升高RAW264.7细胞抗原分化簇(cluster of differentiation, CD) 80 (P<0.01)和诱导型一氧化氮合酶(inducible nitric oxide sy...     

多糖调控p53信号网络研究进展

肿瘤抑制基因p53是目前研究最广泛和系统的抑癌基因之一。p53与其上、下游基因形成复杂的信号网络来发挥功能。p53基因的突变或缺失与多种人类恶性肿瘤的发生、发展密切相关,所以p53基因是目前多种抗肿瘤药物开发的靶点。多糖由于其低毒和抗肿瘤效果成为生物大分子抗肿瘤的研究热点。目前认为,多糖在体内外抗肿瘤机制有两方面:一是通过增强机体免疫力以抑制肿瘤增殖,另一则是激活胞内信号通路,调控肿瘤相关基因表达,诱导肿瘤细胞衰老、细胞周期阻滞与凋亡达到对肿瘤细胞的抑制作用。该文综述了近些年多糖通过调控p53信号网络来发挥其抗肿瘤及抗衰老等作用,为多糖的开发与利用提供参考依据。     

肿瘤患者CD8+T细胞中CD28表达的研究进展

CD28与B7结合形成的共刺激信号是T细胞激活的第二信号,肿瘤患者CD8^＋T细胞上CD28分子在肿瘤免疫中发挥着重要作用。人体抗肿瘤免疫主要由CD8^＋T细胞介导,根据CD28的表达与否可将CD8^＋T细胞分为细胞毒T细胞（CD8^＋CD28^＋,CTL）和抑制性T细胞（CD8^＋C28^-,Ts）。CTL是体内杀伤肿瘤细胞的主要功能性细胞之一,当该细胞与肿瘤接触时,通过共刺激信号而被激活,发挥其对肿瘤细胞的杀伤作用;Ts在机体的免疫耐受中发挥作用。现就肿瘤患者CD8^＋T细胞上CD28的表达作一综述。     

磷酸鞘胺醇对小鼠单核巨噬细胞吞噬功能的调控及机制研究

采用Western blot、免疫荧光和PCR检测小鼠单核巨噬细胞系RAW264.7中S1P受体1-3(S1PR1-3)的表达,然后应用吞噬实验和免疫荧光的方法检测磷酸鞘胺醇(sphingosine 1-phosphate,S1P)对其吞噬功能的调节。分别应用药理学工具和小干扰RNA的方法研究S1P调节其吞噬活性的作用机制。结果显示,小鼠单核巨噬细胞系RAW264.7表达S1PR1-3;S1P剂量依赖地增强小鼠单核巨噬细胞系RAW264.7的吞噬功能,应用S1PR2或S1PR3的拮抗剂和si RNAs可抑制S1P增强的小鼠单核巨噬细胞系RAW264.7的吞噬活性;而应用S1PR1的拮抗剂和si S1PR1并不影响S1P增强的RAW264.7的吞噬作用;且S1P可以显著上调RAW264.7中S1PR2和S1PR3的表达,但是不改变S1PR1的表达,提示S1P通过正反馈机制增强其介导的小鼠单核巨噬细胞系RAW264.7的吞噬功能。结果表明,S1P/S1PR2/3信号通路增强小鼠单核巨噬细胞吞噬活性,为单核巨噬细胞吞噬作用的分子机制调控研究提供了新线索。     

microRNA在实体肿瘤免疫反应中的调节作用

免疫反应的作用逐渐成为调节各种复杂癌症的关键因素。免疫治疗也逐渐成为癌症肿瘤的有效干预方式。肿瘤微环境包含不同类型的免疫细胞,这有助于调节抗肿瘤信号中先天性和适应性免疫系统之间的细微平衡。在这种环境下,肿瘤细胞与免疫细胞之间相互关联的机制有待广泛阐明,但目前已被证明,多种microRNA在实体肿瘤相关免疫细胞的发育和功能中起调控作用,其通过肿瘤及免疫细胞介导免疫抑制或免疫刺激因子分泌增强或抑制免疫应答,靶向调控肿瘤发生的相关免疫途径,从而在癌症起始、转移进展的所有阶段中起关键作用,近而在肿瘤免疫治疗中寻找新的治疗靶点。本文针对microRNA在肿瘤免疫反应中的相关调节进行综述。     

Elimination of tumor by CD47/PD-L1 dual-targeting fusion protein that engages innate and adaptive immune responses

The host immune system generally serves as a barrier against tumor formation. Programmed death-ligand 1 (PD-L1) is a critical “don't find me” signal to the adaptive immune system, whereas CD47 transmits an anti-phagocytic signal, known as the “don't eat me” signal, to the innate immune system. These and similar immune checkpoints are often overexpressed on human tumors. Thus, dual targeting both innate and adaptive immune checkpoints would likely maximize anti-tumor therapeutic effect and elicit more durable responses. Herein, based on the variable region of atezolizumab and consensus variant 1 (CV1) monomer, we constructed a dual-targeting fusion protein targeting both CD47 and PD-L1 using “Knobs-into-holes” technology, denoted as IAB. It was effective in inducing phagocytosis of tumor cells, stimulating T-cell activation and mediating antibody-dependent cell-mediated cytotoxicity in vitro. No obvious sign of hematological toxicity was observed in mice administered IAB at a dose of 100 mg/kg, and IAB exhibited potent antitumor activity in an immune-competent mouse model of MC38. Additionally, the anti-tumor effect of IAB was impaired by anti-CD8 antibody or clodronate liposomes, which implied that both CD8+ T cells and macrophages were required for the anti-tumor efficacy of IAB and IAB plays an essential role in the engagement of innate and adaptive immune responses. Collectively, these results demonstrate the capacity of an elicited endogenous immune response against tumors and elucidate essential characteristics of synergistic innate and adaptive immune response, and indicate dual blockade of CD47 and PD-L1 by IAB may be a synergistic therapy that activates both innate and adaptive immune response against tumors.     

Macrophages are critical effectors of antibody therapies for cancer

Macrophages are innate immune cells that derive from circulating monocytes, reside in all tissues, and participate in many states of pathology. Macrophages play a dichotomous role in cancer, where they promote tumor growth but also serve as critical immune effectors of therapeutic antibodies. Macrophages express all classes of Fcγ receptors, and they have immense potential to destroy tumors via the process of antibody-dependent phagocytosis. A number of studies have demonstrated that macrophage phagocytosis is a major mechanism of action of many antibodies approved to treat cancer. Consequently, a number of approaches to augment macrophage responses to therapeutic antibodies are under investigation, including the exploration of new targets and development of antibodies with enhanced functions. For example, the interaction of CD47 with signal-regulatory protein α (SIRPα) serves as a myeloid-specific immune checkpoint that limits the response of macrophages to antibody therapies, and CD47-blocking agents overcome this barrier to augment phagocytosis. The response of macrophages to antibody therapies can also be enhanced with engineered Fc variants, bispecific antibodies, or antibody-drug conjugates. Macrophages have demonstrated success as effectors of cancer immunotherapy, and further investigation will unlock their full potential for the benefit of patients.     

A bispecific antibody targeting CD47 and CD20 selectively binds and eliminates dual antigen expressing lymphoma cells

Agents that block the anti-phagocytic signal CD47 can synergize with pro-phagocytic anti-tumor antigen antibodies to potently eliminate tumors. While CD47 is overexpressed on cancer cells, its expression in many normal tissues may create an ‘antigen sink’ that could minimize the therapeutic efficacy of CD47 blocking agents. Here, we report development of bispecific antibodies (BsAbs) that co-target CD47 and CD20, a therapeutic target for non-Hodgkin lymphoma (NHL), that have reduced affinity for CD47 relative to the parental antibody, but retain strong binding to CD20. These characteristics facilitate selective binding of BsAbs to tumor cells, leading to phagocytosis. Treatment of human NHL-engrafted mice with BsAbs reduced lymphoma burden and extended survival while recapitulating the synergistic efficacy of anti-CD47 and anti-CD20 combination therapy. These findings serve as proof of principle for BsAb targeting of CD47 with tumor-associated antigens as a viable strategy to induce selective phagocytosis of tumor cells and recapitulate the synergy of combination antibody therapy. This approach may be broadly applied to cancer to add a CD47 blocking component to existing antibody therapies.     

“Velcro” Engineering of High Affinity CD47 Ectodomain as Signal Regulatory Protein α (SIRPα) Antagonists That Enhance Antibody-dependent Cellular Phagocytosis

CD47 is a cell surface protein that transmits an anti-phagocytic signal, known as the “don''t-eat-me” signal, to macrophages upon engaging its receptor signal regulatory protein α (SIRPα). Molecules that antagonize the CD47-SIRPα interaction by binding to CD47, such as anti-CD47 antibodies and the engineered SIRPα variant CV1, have been shown to facilitate macrophage-mediated anti-tumor responses. However, these strategies targeting CD47 are handicapped by large antigen sinks in vivo and indiscriminate cell binding due to ubiquitous expression of CD47. These factors reduce bioavailability and increase the risk of toxicity. Here, we present an alternative strategy to antagonize the CD47-SIRPα pathway by engineering high affinity CD47 variants that target SIRPα, which has restricted tissue expression. CD47 proved to be refractive to conventional affinity maturation techniques targeting its binding interface with SIRPα. Therefore, we developed a novel engineering approach, whereby we augmented the existing contact interface via N-terminal peptide extension, coined “Velcro” engineering. The high affinity variant (Velcro-CD47) bound to the two most prominent human SIRPα alleles with greatly increased affinity relative to wild-type CD47 and potently antagonized CD47 binding to SIRPα on human macrophages. Velcro-CD47 synergizes with tumor-specific monoclonal antibodies to enhance macrophage phagocytosis of tumor cells in vitro, with similar potency as CV1. Finally, Velcro-CD47 interacts specifically with a subset of myeloid-derived cells in human blood, whereas CV1 binds all myeloid, lymphoid, and erythroid populations interrogated. This is consistent with the restricted expression of SIRPα compared with CD47. Herein, we have demonstrated that “Velcro” engineering is a powerful protein-engineering tool with potential applications to other systems and that Velcro-CD47 could be an alternative adjuvant to CD47-targeting agents for cancer immunotherapy.     

Regulation of CD47 expression by interferon-gamma in cancer cells

The anti-phagocytosis signal, CD47, prevents phagocytosis when it interacts with signal-regulatory protein alpha (SIRPα) on macrophages. Given the vital role of CD47 in immune response, further investigation on the regulation of CD47 in tumor microenvironment is needed. Herein, we identified that interferon-gamma (IFN-γ), one of the most important cytokines in the immune and inflammatory response, up-regulated CD47 expression in cancer cells and this effect could be inhibited by the JAK1/2 inhibitor ruxolitinib, as well as siRNA-mediated silencing of JAK1, STAT1, and IRF1. The IFN-γ-induced surface expression of CD47 contributed to a stronger binding affinity to SIRPα and a decrease in phagocytosis of cancer cells by macrophages. Knockdown of JAK1, STAT1, or IRF1 by siRNA reversed the decreased phagocytosis caused by IFN-γ. Besides, analysis from TCGA revealed that IFNG had a positive correlation with CD47 in various types of cancer, which was supported by the increased surface CD47 expression after IFN-γ treatment in different types of cancer cells. The discovery of IFN-γ-induced up-regulation of CD47 in cancer cells unveils another feedback inhibitory mechanism of IFN-γ, thus providing insights into cancer immunotherapy targeting CD47.     

Macrophages are critical effectors of antibody therapies for cancer

Macrophages are innate immune cells that derive from circulating monocytes, reside in all tissues, and participate in many states of pathology. Macrophages play a dichotomous role in cancer, where they promote tumor growth but also serve as critical immune effectors of therapeutic antibodies. Macrophages express all classes of Fcγ receptors, and they have immense potential to destroy tumors via the process of antibody-dependent phagocytosis. A number of studies have demonstrated that macrophage phagocytosis is a major mechanism of action of many antibodies approved to treat cancer. Consequently, a number of approaches to augment macrophage responses to therapeutic antibodies are under investigation, including the exploration of new targets and development of antibodies with enhanced functions. For example, the interaction of CD47 with signal-regulatory protein α (SIRPα) serves as a myeloid-specific immune checkpoint that limits the response of macrophages to antibody therapies, and CD47-blocking agents overcome this barrier to augment phagocytosis. The response of macrophages to antibody therapies can also be enhanced with engineered Fc variants, bispecific antibodies, or antibody-drug conjugates. Macrophages have demonstrated success as effectors of cancer immunotherapy, and further investigation will unlock their full potential for the benefit of patients.     

Therapeutic targeting of the thrombospondin-1 receptor CD47 to treat liver cancer

CD47 is a signaling receptor for the matricellular protein thrombospondin-1 and a counter-receptor for signal regulatory protein-α (SIRPα) on macrophages. Following its initial discovery in 1992 as a cell surface protein that is over-expressed by ovarian carcinoma, elevated CD47 expression has emerged as a negative prognostic factor for a variety of cancers. CD47 is also a potential therapeutic target based on the ability of CD47 blockade to cause regression of tumors in mice, and a humanized CD47 antibody has recently entered phase I clinical trials. CD47 blockade may control tumor growth by inhibiting thrombospondin-1 signaling or by preventing inhibitory SIRPα signaling in tumor-associated macrophages. A recent publication by Lee et al. (Hepatology 60:179–191, 2014) provides evidence that blocking CD47 signaling specifically depletes tumor-initiating stem cells in hepatocellular carcinoma and implicates cathepsin-S/protease-activated receptor-2 signaling in mediating this therapeutic response.     

The tumor immunosuppressive microenvironment impairs the therapy of anti-HER2/neu antibody

It has been well established that immune surveillance plays critical roles in preventing the occurrence and progression of tumor. More and more evidence in recent years showed the host anti-tumor immune responses also play important roles in the chemotherapy and radiotherapy of cancers. Our previous study found that tumor- targeting therapy of anti-HER2/neu mAb is mediated by CD8⁺ T cell responses. However, we found here that enhancement of CD8⁺ T cell responses by combination therapy with IL-15R/IL-15 fusion protein or anti-CD40, which are strong stimultors for T cell responses, failed to promote the tumor therapeutic effects of anti-HER2/neu mAb. Analysis of tumor microenviornment showed that tumor tissues were heavily infiltrated with the immunosuppressive macrophages and most tumor infiltrating T cells, especially CD8⁺ T cells, expressed high level of inhibitory co-signaling receptor PD-1. These data suggest that tumor microenvironment is dominated by the immunosuppressive strategies, which thwart anti-tumor immune responses. Therefore, the successful tumor therapy should be the removal of inhibitory signals in the tumor microenvironment in combination with other therapeutic strategies.     

Blocking monoclonal antibodies of TIM proteins as orchestrators of anti-tumor immune response

Monoclonal antibody (mAb)-based treatment of cancer has a significant effect on current practice in medical oncology, and is considered now as one of the most successful therapeutic strategies for cancer treatment. MAbs are designed to initiate or enhance anti-tumor immune responses, which can be achieved by either blocking inhibitory immune checkpoint molecules or triggering activating receptors. TIM gene family members are type-I surface molecules expressed in immune cells, and play important roles in the regulation of both innate and adaptive arms of the immune system. Therapeutic strategies based on anti-TIMs mAbs have shown promising results in experimental tumor models, and synergistic combinations of anti-TIMs mAbs with cancer vaccines, adoptive T-cell therapy, radiotherapy and chemotherapy will have great impact on cancer treatment in future clinical development.