吉林大学学报(医学版)

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CD4+T细胞介导的免疫耐受对恶性胸腔积液发生发展影响的研究进展

阿格尔,王芹,焦丽静,周海伦,甘姗珊,韩阳,刘睿潮,龚亚斌()   

  1. 上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437
  • 收稿日期:2024-05-13
  • 通讯作者: 龚亚斌 E-mail:gongyabin@hotmail.com
  • 作者简介:阿格尔(1999-),女,辽宁省阜新市人,在读硕士研究生,主要从事中医药防治恶性肿瘤方面的研究。
  • 基金资助:
    国家自然科学基金项目(82074339);上海市卫健委科研项目[ZY(2018-2020)-FWTX-6009]

Research progress in effects of CD4+T cell-mediated immune tolerance on the occurrence and development of malignant pleural effusion

Ageer,Qin WANG,Lijing JIAO,Hailun ZHOU,Shanshan GAN,Yang HAN,Ruichao LIU,Yabin GONG()   

  1. First department of Oncology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China
  • Received:2024-05-13
  • Contact: Yabin GONG E-mail:gongyabin@hotmail.com

摘要:

恶性胸腔积液(MPE)是晚期恶性肿瘤患者常见的并发症,其严重影响患者的生活质量并缩短患者生存期。尽管传统的治疗手段(胸腔穿刺引流和胸膜固定术等)已被广泛使用,但疗效有限且复发率较高。因此,探索新的治疗策略变得尤为迫切。近年来,免疫疗法因其在肿瘤治疗中的潜力而受到广泛关注。本文通过系统综述,主要探讨CD4+T细胞亚群,包括调节性T细胞(Treg)、辅助性T细胞(Th)17细胞、Th9细胞和Th22细胞在MPE免疫抑制微环境中的作用。这些细胞亚群通过多种机制参与了MPE的免疫抑制状态的形成,对疾病的发生和发展起到了关键作用。本文还详细讨论了免疫检查点分子,如程序性死亡蛋白1(PD-1)、其配体PD-L1以及细胞毒性T淋巴细胞相关蛋白4(CTLA-4)在MPE免疫逃逸中的作用。这些分子的异常表达为肿瘤细胞提供了逃避免疫系统监视的机会。本文对过继性细胞疗法(ACT)和嵌合抗原受体T细胞(CAR-T)疗法等新型免疫治疗策略在MPE治疗中的应用前景进行了总结。上述创新疗法通过激活和增强机体的抗肿瘤免疫反应,为改善MPE患者的预后提供了新的可能性。

关键词: 恶性胸腔积液, 免疫耐受, 调节性T细胞, 辅助性T细胞17细胞, 辅助性T细胞9细胞, 辅助性T细胞22细胞

Abstract:

Malignant pleural effusion (MPE) is a common complication in patients with advanced malignant tumors,which not only significantly reduces their quality of life but also shortens their survival duration. Despite the widespread use of traditional treatment methods such as thoracentesis and pleurodesis,their efficacy is limited accompanied by high recurrence rates. Therefore,exploring novel therapeutic strategies becomes particularly urgent. In recent years, immunotherapy has attracted extensive attention for its potential in cancer treatment. This article systematically reviews the roles of CD4+T cell subsets,including regulatory T cells (Treg), T helper cell(Th)17, Th9, and Th22 cells, within the immunosuppressive microenvironment of MPE. These cell subsets are involved in the formation of the immunosuppressive state of MPE through various mechanisms and play key roles in the occurrence and development of the disease. In addition,the article discusses in detail the role of immune checkpoint molecules,such as programmed death protein 1 (PD-1), PD-1 ligand(PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), in the immune evasion of MPE. The abnormal expressions of these molecules provide opportunity for tumor cells to evade immune system surveillance. This article also summarizes the application prospects of novel immunotherapy strategies, such as adoptive cell therapy (ACT) and chimeric antigen receptor T cell (CAR-T) therapy,in the treatment of MPE. These innovative therapies offer possibilities for improving the prognosis of MPE patients through activating and enhancing the anti-tumor immune response.

Key words: Malignant pleural effusion, Immune tolerance, Regulatory T cells, T helper 17 cells, T helper 9 cells, T helper 22 cells

中图分类号: 

  • R734.3