免疫检查点蛋白质PD-1的信号转导通路与肿瘤免疫治疗

程序性死亡受体-1(programmed death-1,PD-1)是B7-CD28(B7 family-cluster of differentiation28)家族最新发现的成员,其在肿瘤免疫逃逸和免疫耐受中发挥着重要的作用。PD-1作为抑制性受体,在T细胞的信号转导中发挥着关键性作用,能够通过阻断与PD-1/程序性死亡受体-1配体-1(programmed death-1 ligand-1,PD-L1)信号通路,能够促进T淋巴细胞的增殖和分化,从而激活抗肿瘤免疫反应。而作为PD-1配体的PD-L2,除了在肿瘤免疫中发挥作用外,还在哮喘、过敏性反应等方面起着重要作用。该文就PD-1、PD-Ls与PD-1/PD-Ls信号通路以及PD-1抗体在肿瘤免疫治疗中的应用作一综述。     

CTLA-4和PD-1信号通路在实体瘤治疗中的研究进展

细胞毒性T淋巴细胞相关抗原4(cytotoxic T-lymphocyte-associated antigen 4,CTLA-4)和程序性死亡受体1(programmed death 1,PD-1)免疫检查点在T细胞免疫反应中起负性调节作用。通过对这些靶点的抑制,可增强对免疫系统的激活,为黑色素瘤、非小细胞肺癌等提供新的免疫治疗途径。CTLA-4和PD-1信号通路在免疫反应及抗肿瘤中机制有所不同,针对这两条信号通路的免疫检查点抑制剂也具有不同的效应。现将综述CTLA-4和PD-1信号通路的作用机制及相应靶点阻断剂在实体肿瘤免疫治疗中的应用及研究进展。     

以PD-1 为靶点的抗肿瘤药物专利现状分析

PD-1(程序性死亡受体1)是一种重要的免疫抑制分子,其与癌症的治疗密切相关。目前FDA(美国食品药品监督管理局)已经批准了PD-1抑制剂抗体作为癌症治疗药,因此,PD-1具有极高的研究和应用价值。目前在专利领域,全球各大药企均已经开始专利布局,而在中国申请的专利也是日趋增多,对于我国企业来说,把握时机提前布局专利申请,有利于识别竞争对手,抢占市场。本文通过分析以PD-1为靶点的药物专利现状,特别是研究的重点领域,专利申请的国内重点布局等方面,为国内的申请人未来的研发方向和专利布局提供适当的指引。     

本庶佑的科学贡献

<正>本庶佑的主要贡献在于:首次发现了免疫系统的PD-1的信号通路,揭示表达在T淋巴细胞表面的PD-1分子是一个T细胞功能的"刹车"分子,阻断PD-1分子后可以有效抗击癌症。说明一下:本庶佑发现PD-1的时间是在1992年,比艾利森发现CTLA-4的作用这一重大发现还要早4年。     

PD-1及其配体在非小细胞肺癌中的研究现状与展望

摘要：肺癌是全球最常见肿瘤之一,其中非小细胞肺癌（NSCLC）约占肺癌的85%。目前肺癌的治疗手段仍然有限,并且晚期肺癌的预后较差,严重影响患者的生命健康。程序性死亡受体1（PD-1）及其配体程序性死亡配体1（PD-L1）属于CD28/B7家族的共刺激分子,可负性调控T细胞免疫功能,使肿瘤细胞免于机体免疫系统的监视和清除。以PD-1/PD-L1单抗为代表的免疫治疗成为继手术治疗、化疗、放疗、分子靶向治疗之后的新焦点,针对PD-1/PD-L1通路的靶向治疗药物纳武单抗（Nivolumab）、派姆单抗（Pembrolizumab）已被食品药品管理局（FDA）批准投入临床使用,且已被国家综合癌症网络（NCCN）推荐为转移性肺癌的一线治疗药物。本文就PD-1/PD-L1的生物学结构及其在NSCLC中的作用机制、靶向药物、研究现状及展望展开综述。     

恩替卡韦对CHB患者外周血T淋巴细胞PD-1水平及肝功能的影响

目的探讨恩替卡韦对慢性乙型肝炎(CHB)患者外周血T淋巴细胞程序性死亡受体1(PD-1)水平及肝功能的影响。方法将128例CHB患者随机分为观察组及对照组各64例,对照组患者给予拉米夫定治疗,观察组在对照组基础上给予恩替卡韦治疗。分别于治疗前、治疗后1个月、3个月、6个月、12个月抽取静脉血5 m L,采用荧光定量PCR检测患者血清HBV DNA载量,流式细胞术检测T淋巴细胞PD-1表达水平,全自动化生化分析仪测定患者血清谷草转氨酶(ALT)水平。结果两组组患者治疗1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+T细胞PD-1、CD8+T细胞PD-1水平均低于治疗前(P0.05)。观察组治疗后1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+T细胞PD-1、CD8+T细胞PD-1水平低于对照组(P0.05)。结论恩替卡韦能有效抑制CHB患者外周血CD4+、CD8+T细胞表面PD-1表达水平,进而抑制HBV DNA复制,改善患者肝功能。     

PD-1胞外段cDNA在真核细胞的表达与其功能鉴定

PD-L/PD-1是参与肿瘤免疫逃避的一条抑制性信号途径。为了用可溶性的PD 1受体阻断PD-L/PD-1的相互作用 ,将小鼠PD-1胞外段 (aa1-aa167)作为独立可溶性分子进行了真核表达 ,并对其功能进行鉴定。构建了编码小鼠PD-1胞外段cDNA(sPD 1)的真核质粒表达载体pPD-1A和编码sPD-1-GFP重组蛋白的真核质粒表达载体pPD-1B ;细胞转染实验表明其表达产物主要是分泌到细胞外的可溶性产物 (sPD-1) ,流式细胞仪检测表明sPD-1可有效结合PD-1配体 ;肿瘤细胞杀伤实验表明 ,sPD-1作用于肿瘤细胞或在脾淋巴细胞激活过程中作用于淋巴细胞 ,均可增强Hsp70-H22抗原肽复合物激活的脾淋巴细胞杀伤肿瘤细胞的作用。sPD-1真核表达载体的构建为在肿瘤局部表达抑制性共刺激分子的可溶性受体 ,拮抗肿瘤微环境中负调节因素对T细胞的抑制作用 ,增强机体的抗肿瘤能力 ,提供了一种新的肿瘤基因治疗手段     

程序性死亡-1蛋白及其配体与移植免疫耐受相关性研究进展

通过对B7超家族分子中新热点:程序性死亡-1蛋白(PD-1)及其配体(PD-L1和PD-L2)的相关信息及其在免疫应答调控中的作用,以及其在心脏移植、肝脏移植、异体角膜移植、肾移植等领域的移植免疫耐受研究的结果认为,PD-1信号通路的增强已经成为各移植领域寻求增强免疫耐受的重要新途径,对其机制的进一步研究,将在临床器官移植领域拥有广阔的应用前景。     

靶向肿瘤微环境的CAR-T治疗研究*

癌症仍然是现阶段威胁人类健康的一大难题,随着医学的发展,癌症治疗方法除传统方法:手术、放疗、化疗,还可以采用免疫疗法。目前,癌症免疫疗法受到广泛关注,但在应用方面具有许多局限性,如 PD-1/PD-L1 抑制剂,在应用的过程中会出现获得性耐药现象,因此细胞免疫疗法(chimeric antigen receptor T cell, CAR-T) 应运而生,成为弥补免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)和单克隆抗体药物缺陷的新兴治疗方式,简要介绍了 CAR-T 免疫疗法的产生、应用及对 TME 相关靶点的研究进展,为后续研究提供一定的思路。     

靶向肿瘤微环境的CAR-T治疗研究*

癌症仍然是现阶段威胁人类健康的一大难题,随着医学的发展,癌症治疗方法除传统方法:手术、放疗、化疗,还可以采用免疫疗法。目前,癌症免疫疗法受到广泛关注,但在应用方面具有许多局限性,如 PD-1/PD-L1 抑制剂,在应用的过程中会出现获得性耐药现象,因此细胞免疫疗法(chimeric antigen receptor T cell, CAR-T) 应运而生,成为弥补免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)和单克隆抗体药物缺陷的新兴治疗方式,简要介绍了 CAR-T 免疫疗法的产生、应用及对 TME 相关靶点的研究进展,为后续研究提供一定的思路。     

PD-1/PD-L1与Treg细胞相关性的研究新进展

PD-1和PD-L属于B7家族的共刺激分子,介导免疫反应的负性调节信号。Treg细胞是一个具有免疫调节作用的T细胞亚群,在机体的免疫耐受和免疫稳定中具有重要作用。本文就PD-1/PD-L1与Treg细胞的免疫调节作用及相关性研究进展作简要综述。     

PD-1/PD-L1-dependent immune response in colorectal cancer

Colorectal cancer (CRC) is still considered as the third most frequent cancer in the world. Microsatellite instability (MSI), inflammation, and microRNAs have been demonstrated as the main contributing factors in CRC. Subtype 1 CRC is defined by NK cells infiltration, induction of Th1 lymphocyte and cytotoxic T cell responses as well as upregulation of immune checkpoint proteins including programmed cell death-1 (PD-1). Based on the diverse features of CRC, such as the stage and localization of the tumor, several treatment approaches are available. However, the efficiency of these treatments may be decreased due to the development of diverse resistance mechanisms. It has been proven that monoclonal antibodies (mAbs) can increase the effectiveness of CRC treatments. Nowadays, several mAbs including nivolumab and pembrolizumab have been approved for the treatment of CRC. Immune checkpoint receptors including PD-1 can be inhibited by these antibodies. Combination therapy gives an opportunity for advanced treatment for CRC patients. In this review, an update has been provided on the molecular mechanisms involved in MSI colorectal cancer immune microenvironment by focusing on PD-ligand 1 (PD-L1) and treatment of patients with advanced immunotherapy, which were examined in the different clinical trial phases. Considering induced expression of PD-L1 by conventional chemotherapeutics, we have summarized the role of PD-L1 in CRC, the chemotherapy effects on the PD-1/PD-L1 axis and novel combined approaches to enhance immunotherapy of CRC by focusing on PD-L1.     

Revisiting PD-1/PD-L pathway in T and B cell response: Beyond immunosuppression

The regulation of T cell response depends on co-inhibitory pathways that serve to control immune-mediated tissue damage and resolve inflammation by modulating the magnitude and duration of immune response. In this process, the axis of T-cell-expressed programmed death-1 (PD-1) and its ligands (PD-L1 and PD-L2) play a key role. While the PD-1/PD-L pathway has received considerable attention for its role in the maintenance of T cell exhaustion in cancer and chronic infection, the PD-1/PD-L pathway also plays diverse roles in regulating host immunity beyond T cell exhaustion. In this review, we will discuss emerging concepts in co-stimulatory functions of PD-1/PD-L pathway on T cell- and B cell response and explore the potential underlying mechanisms. In addition, based on the elevated expression of PD-1 and its ligands in local inflamed tissues, we further discussed the role of PD-1/PD-L pathway in autoimmune diseases.     

PD-1 Regulates Neural Damage in Oligodendroglia-Induced Inflammation

We investigated the impact of immune regulatory mechanisms involved in the modulation of the recently presented, CD8+ lymphocyte mediated immune response in a mouse model of oligodendropathy-induced inflammation (PLPtg-mutants). The focus was on the role of the co-inhibitory molecule PD-1, a CD28-related receptor expressed on activated T- and B-lymphocytes associated with immune homeostasis and autoimmunity. PLPtg/PD-1-deficient double mutants and the corresponding bone marrow chimeras were generated and analysed using immunohistochemistry, light- and electron microscopy, with particular emphasis on immune-cell number and neural damage. In addition, the immune cells in both the CNS and the peripheral immune system were investigated by IFN-gamma elispot assays and spectratype analysis. We found that mice with combined pathology exhibited significantly increased numbers of CD4+ and CD8+ T-lymphocytes in the CNS. Lack of PD-1 substantially aggravated the pathological phenotype of the PLPtg mutants compared to genuine PLPtg mutants, whereas the PD-1 deletion alone did not cause alterations in the CNS. CNS T-lymphocytes in PLPtg/PD-1-/- double mutants exhibited massive clonal expansions. Furthermore, PD-1 deficiency was associated with a significantly higher propensity of CNS but not peripheral CD8+ T-cells to secrete proinflammatory cytokines. PD-1 could be identified as a crucial player of tissue homeostasis and immune-mediated damage in a model of oligodendropathy-induced inflammation. Alterations of this regulatory pathway lead to overt neuroinflammation of high pathogenetic impact. Our finding may have implications for understanding the mechanisms leading to the high clinical variability of polygenic or even monogenic disorders of the nervous system.     

N6-methyladenosine RNA modification in PD-1/PD-L1: Novel implications for immunotherapy

Cancer immunotherapy has been shown to achieve significant antitumor effects in a variety of malignancies. Out of all the immune checkpoint molecules, PD-1/PD-L1 inhibitor therapy has achieved great success. However, only some cancer patients benefit from this treatment strategy owing to drug resistance. Therefore, identifying the underlying modulators of the PD-1/PD-L1 pathway to completely comprehend the mechanisms of anti-PD-1/PD-L1 treatment is crucially important. Recent research has validated that m6A modification plays a critical role in the PD-1/PD-L1 axis, thus regulating the immune response and immunotherapy strategies. In this review, we summarized the latest research on the regulation of m6A modification in PD-1/PD-L1 pathways in cancer proliferation, invasion, and prognosis based on different kinds of cancers and discussed the possible mechanisms. We also reviewed m6A-associated lncRNAs in the regulation of the PD-1/PD-L1 pathway. More importantly, we outlined the influence of m6A modulation on anti-PD-1 therapy and m6A-related molecules that could predict the curative effect of anti-PD-1/PD-L1 therapy. Further studies exploring the definitive regulation of m6A on the PD1/PD-1 pathway and immunotherapy are needed, which may address some of the current limitations in immunotherapy.     

PD-1核心启动子的获得及活性鉴定

目的:构建PD-1(programmed death receptor 1)全长启动子及不同截短体的报告基因,并对其转录活性进行检测。方法:通过PCR及双酶切方法,从人全血基因组DNA中获得PD-1基因编码序列,包含不同长度碱基的PD-1启动子序列,分别克隆到报告基因pGL3-Basic载体上,构建8个不同长度PD-1启动子的报告基因;用脂质体转染法将8个报告基因分别转染至Jurkat细胞系;采用双萤光素酶报告基因系统评估PD-1启动子的活性。结果:经PCR方法扩增出大小分别为1650、1450、1250、1128、874、674、474和274 bp的不同长度的PD-1启动子序列,测序正确(与GenBank报道一致),酶切鉴定正确;瞬时转染Jurkat细胞系后经报告基因检测,8个启动子均具有转录活性。结论:构建了PD-1启动子的报告基因,并证实均有转录活性,且以pGL3-1128活性最高,为PD-1的核心启动子,为进一步研究PD-1的转录调控奠定了实验基础。     

Programmed death-1 (PD-1):PD-ligand 1 interactions inhibit TCR-mediated positive selection of thymocytes

Positive selection during thymocyte development is driven by the affinity and avidity of the TCR for MHC-peptide complexes expressed in the thymus. In this study, we show that programmed death-1 (PD-1), a member of the B7/CD28 family of costimulatory receptors, inhibits TCR-mediated positive selection through PD-1 ligand 1 (PD-L1):PD-1 interactions. Transgenic mice that constitutively overexpress PD-1 on CD4+CD8+ thymocytes display defects in positive selection in vivo. Using an in vitro model system, we find that PD-1 is up-regulated following TCR engagement on CD4+CD8+ murine thymocytes. Coligation of TCR and PD-1 on CD4+CD8+ thymocytes with a novel PD-1 agonistic mAb inhibits the activation of ERK and up-regulation of bcl-2, both of which are downstream mediators essential for positive selection. Inhibitory signals through PD-1 can overcome the ability of positive costimulators, such as CD2 and CD28, to facilitate positive selection. Finally, defects in positive selection that result from PD-1 overexpression in thymocytes resolve upon elimination of PD-L1, but not PD-1 ligand 2, expression. PD-L1-deficient mice have increased numbers of CD4+CD8+ and CD4+ thymocytes, indicating that PD-L1 is involved in normal thymic selection. These data demonstrate that PD-1:PD-L1 interactions are critical to positive selection and play a role in shaping the T cell repertoire.     

Is it true that gut microbiota is considered as panacea in cancer therapy?

Recent studies demonstrated that a combination of the gut microbiome has the vital effect on the efficacy of anticancer immune therapies. Regulatory effects of microbiota have been shown in different types of cancer therapies such as chemotherapy and immunotherapy. Immune-checkpoint-blocked therapies are the recent efficient cancer immunotherapy strategies. The target of immune-checkpoint blocking is cytotoxic T lymphocyte protein-4 (CTLA-4) or blockade of programmed death-1 (PD-1) protein and its ligand programmed death ligand 1 (PD-L1) that they have been considered as cancer immunotherapy in recent years. In the latest studies, it have been demonstrated that several gut bacteria such as Akkermansia muciniphila, Bifidobacterium spp., Faecalibacterium spp., and Bacteroides fragilis have the regulatory effects on PD-1, PD-L1, and CTLA-4 blocked anticancer therapy outcome.     

肺癌性胸腔积液中生存素基因检测的诊断意义探讨

目的：生存素基因（survivin）是一种新近发现的抗凋亡基因,在肿瘤组织中呈现表达。本文旨在探讨和比较肺癌性胸腔积液和结核性胸腔积液中生存素基因的表达情况,以及其联合细胞学检查对判断肺癌性胸腔积液的敏感度。方法：应用逆转录酶-聚合酶链反应法（RT-PCR）检测2007年06月～2008年03月42例肺癌患者癌性胸腔积液标本,及同时期28例结核性胸腔积液标本的生存素mRNA表达情况,并联合细胞学检查结果进行对比分析。结果：42例肺癌患者胸腔积液标本中生存素mRNA的阳性率为52138％（22／42）;癌细胞的检出率为30．95％（13／42）;生存素mRNA检测联合细胞学检查诊断肺癌的敏感性为61．90％（26／42）,显著高于单独胸腔积液细胞学检测的敏感性（P〈0．001）。28例结核性胸腔积液标本的生存素mRNA阳性率为7．14％（2／28）,显著低于肺癌患者胸腔积液标本生存素mRNA的阳性率（P〈0．001）。结论：运用RT—PCR方法检测胸腔积液中生存素mRNA的表达在判断肺癌性胸腔积液中具有一定的敏感性和特异性,可能作为肺癌辅助诊断的一个新检测指标。