“三联疗法”抗肿瘤效果最强!华中科技大学同济医学院附庸协和医院徐双兵、陈静颁布肺癌治疗新策略
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240325/25b24dd67a9a45c4bce68e386c541388.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">作者:Sophia</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">导读:</strong>肿瘤细胞<span style="color: black;">经过</span>程序性死亡配体 1 (PD-L1) 逃避免疫反应已被确定为<span style="color: black;">引起</span>肺癌<span style="color: black;">病人</span>对放射免疫治疗产生耐药性的一个<span style="color: black;">原因</span>。然而,PD-L1调控的确切分子机制仍不完全清楚。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2024年3月22日,华中科技大学同济医学院<span style="color: black;">附庸</span>协和医院徐双兵教授和陈静教授<span style="color: black;">一起</span>通讯在《Journal of Experimental & Clinical Cancer Research》上<span style="color: black;">发布</span>题为“CDKL1 potentiates the antitumor efficacy of radioimmunotherapy by binding to tranion factor YBX1 and blocking PD-L1 expression in lung cancer”的<span style="color: black;">科研</span>论文,<strong style="color: blue;"><span style="color: black;">科研</span><span style="color: black;">发掘</span>,CDKL1下调并<span style="color: black;">控制</span>肺癌细胞的生长和增殖,并<span style="color: black;">增多</span>体外和<span style="color: black;">身体</span>的放射<span style="color: black;">敏锐</span>性。从机制上讲,CDKL1 与转录因子 YBX1 相互<span style="color: black;">功效</span>,降低 YBX1 对 PD-L1 基因<span style="color: black;">起步</span>子的结合亲和力,从而<span style="color: black;">控制</span> PD-L1 的表达,<span style="color: black;">最后</span><span style="color: black;">引起</span> CD8 T 细胞的活化和肺癌免疫逃逸的<span style="color: black;">控制</span>。<span style="color: black;">另外</span>,CDKL1 过表达、放疗和抗 PD-L1 抗体疗法的组合对肺癌表现出最有效的抗肿瘤功效。</strong>总之,本<span style="color: black;">科研</span>结果<span style="color: black;">显示</span>,CDKL1在调节PD-L1表达中起着至关<span style="color: black;">要紧</span>的<span style="color: black;">功效</span>,从而<span style="color: black;">加强</span>了放射免疫疗法的抗肿瘤<span style="color: black;">功效</span>。这些结果<span style="color: black;">显示</span>,CDKL1可能是治疗肺癌的一个有前途的治疗靶点。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240325/a5d7252787fc49a198262f942ecac868.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">https://jeccr.biomedcentral.com/articles/10.1186/s13046-024-03007-w</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">科研</span>背景</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">01 </span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺癌是<span style="color: black;">全世界</span>公认的癌症<span style="color: black;">关联</span>死亡的<span style="color: black;">重点</span><span style="color: black;">原由</span>,<span style="color: black;">亦</span>是癌症中死亡率最高的癌症。肺癌的<span style="color: black;">重点</span>治疗<span style="color: black;">选取</span><span style="color: black;">包含</span>手术<span style="color: black;">干涉</span>、放疗(RT)、化疗、靶向治疗和免疫治疗。在这些方式中,<span style="color: black;">检测</span>点阻断免疫疗法,<span style="color: black;">尤其</span>是针对程序性细胞死亡蛋白 1 (PD-1) 和程序性细胞死亡蛋白 1 配体 1 (PD-L1) 的疗法,已被证明可为非小细胞肺癌(NSCLC)<span style="color: black;">病人</span><span style="color: black;">供给</span><span style="color: black;">长时间</span>临床益处。<span style="color: black;">另外</span>,局部放疗有可能诱导从免疫冷肿瘤表型转变为热肿瘤表型,从而<span style="color: black;">增多</span>免疫治疗的影响。然而,免疫治疗与放疗联合的临床结果仍然不尽如人意。帕博利珠单抗联合放疗治疗的转移性非小细胞肺癌<span style="color: black;">病人</span>的远隔缓解率为 41.7%。<span style="color: black;">海量</span>证据<span style="color: black;">显示</span><strong style="color: blue;">,肿瘤PD-L1的表达水平是<span style="color: black;">评定</span>肺癌<span style="color: black;">病人</span>对抗PD-1/PD-L1治疗临床反应的<span style="color: black;">重要</span>生物标志物。<span style="color: black;">因此呢</span>,探索PD-L1调控机制<span style="color: black;">针对</span>改善肺癌免疫治疗的反应非常<span style="color: black;">要紧</span>。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">研究<span style="color: black;">发展</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">02 </span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤细胞上高水平的 PD-L1 的存在阻碍了 CD8 T 细胞的活化,从而促进了肿瘤细胞的免疫逃避。<span style="color: black;">因此呢</span>,<span style="color: black;">咱们</span>认为 CDKL1 介导的 PD-L1 调节可能会影响 CD8 T 细胞的活化。为了验证这一假设,<span style="color: black;">咱们</span>培养了<span style="color: black;">拥有</span>CDKL1过表达的Lewis细胞和从小鼠脾脏中提取的CD8 T细胞。流式细胞术清楚地<span style="color: black;">显示</span>,当CD8 T细胞与过表达CDKL1的细胞<span style="color: black;">一块</span>培养时,细胞毒性标志物IFN-γ和GZMB的表达<span style="color: black;">明显</span><span style="color: black;">增多</span>(图6A)。随后,<span style="color: black;">咱们</span>将过表达CDKL1的稳定Lewis细胞系接种到C57BL / 6J小鼠中,以<span style="color: black;">创立</span>皮下肿瘤模型。结果<span style="color: black;">表示</span>,<strong style="color: blue;">在CDKL1过表达后,移植肿瘤的生长速度<span style="color: black;">明显</span>减慢,<span style="color: black;">同期</span>肿瘤的湿重降低(图6B,C)。</strong>为了阐明 CDKL1 在免疫逃逸中的<span style="color: black;">功效</span>,<span style="color: black;">咱们</span>将肿瘤移植到单细胞悬浮液中,随后进行流式细胞术染色以<span style="color: black;">评定</span> CD8 T 细胞的比例及其在肿瘤内分泌因子的水平。如图6D所示,在CDKL1过表达的肿瘤中,CD45+细胞中CD8 T细胞的比例<span style="color: black;">增多</span>,伴有IFN-γ和GZMB分泌的增加。这一<span style="color: black;">发掘</span><span style="color: black;">显示</span>,CDKL1<span style="color: black;">拥有</span>刺激CD8 T细胞活化的<span style="color: black;">潜能</span>。总之,<span style="color: black;">咱们</span>的<span style="color: black;">科研</span>结果<span style="color: black;">显示</span>,<strong style="color: blue;">CDKL1诱导CD8 T细胞的活化,从而<span style="color: black;">加强</span>抗肿瘤免疫反应。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/q_70/images03/20240325/8311edddc71140b3a41164b7d5206b5f.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">CDKL1 过表达在<span style="color: black;">身体</span>和体外<span style="color: black;">控制</span>免疫逃避,三联疗法在肺癌中产生最有效的抗肿瘤结果。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">鉴于裸鼠中CDKL1过表达与放疗的联合治疗效果<span style="color: black;">增多</span>,CDKL1过表达<span style="color: black;">控制</span>PD-L1表达<span style="color: black;">同期</span>刺激CD8 T细胞活化,<span style="color: black;">咱们</span>假设CDKL1过表达、放疗和免疫疗法(抗PD-L1抗体)的组合可能协同<span style="color: black;">加强</span>抗肿瘤反应。<span style="color: black;">咱们</span>进行了一项<span style="color: black;">科研</span>,其中<span style="color: black;">咱们</span>实施了单药治疗、双药治疗和三药治疗,<span style="color: black;">触及</span> CDKL1、RT 和抗 PD-L1 免疫疗法的过表达(图 6E)。为了<span style="color: black;">评定</span>这些治疗的疗效,<span style="color: black;">咱们</span><span style="color: black;">创立</span>了9组皮下移植肿瘤的C57BL / 6J小鼠,并<span style="color: black;">评定</span>了这些组的抗肿瘤<span style="color: black;">功效</span>。<span style="color: black;">咱们</span>的<span style="color: black;">科研</span>结果<span style="color: black;">显示</span>,单独<span style="color: black;">运用</span>任何一种疗法治疗都能有效<span style="color: black;">控制</span>肿瘤生长(图6F)。与对照组相比,其中两种疗法的组合<span style="color: black;">拥有</span>更强的阻挠肿瘤生长的能力,而<strong style="color: blue;">三联疗法对肿瘤生长的影响最大(图6F)</strong>。<span style="color: black;">另外</span>,单药组和双药组CD8 T细胞比例和细胞毒性IFN-γ CD8 T细胞比例均有所<span style="color: black;">增多</span>,<strong style="color: blue;">三联疗法组的效果最为<span style="color: black;">显著</span>(图6G,H)</strong>。值得<span style="color: black;">重视</span>的是,<strong style="color: blue;">当CD8 T细胞耗尽时,三联疗法的有效性<span style="color: black;">明显</span>降低(图6F-H),这<span style="color: black;">显示</span>CD8 T细胞在针对肿瘤的免疫反应中不可或缺。</strong>总的<span style="color: black;">来讲</span>,这些<span style="color: black;">发掘</span><span style="color: black;">显示</span>,<strong style="color: blue;">CDKL1过表达、放疗和抗PD-L1抗体治疗的联合给药对肺癌的抗肿瘤<span style="color: black;">功效</span>最强。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">科研</span>结论</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">03 </span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">综上所述,<strong style="color: blue;"><span style="color: black;">咱们</span>的<span style="color: black;">科研</span>全面<span style="color: black;">认识</span>了CDKL1在<span style="color: black;">加强</span>肺癌细胞的放射<span style="color: black;">敏锐</span>性和<span style="color: black;">控制</span>免疫逃逸方面的<span style="color: black;">功效</span>。<span style="color: black;">另外</span>,<span style="color: black;">咱们</span>证明了 CDKL1 与 YBX1 相互<span style="color: black;">功效</span>,<span style="color: black;">经过</span>减少 YBX1 与 PD-L1 <span style="color: black;">起步</span>子的结合<span style="color: black;">引起</span><span style="color: black;">控制</span> PD-L1 表达,从而激活 CD8 T 细胞反应并<span style="color: black;">最后</span><span style="color: black;">引起</span>放射免疫治疗致敏(图 7)。</strong>这些<span style="color: black;">发掘</span>为<span style="color: black;">研发</span>治疗肺癌的放射免疫增敏策略<span style="color: black;">供给</span>了新的分子靶点和临床前证据。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q6.itc.cn/q_70/images03/20240325/1c556d759c274899ad71035c99424af7.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">CDKL1 参与肺癌免疫逃逸的机制模型。</strong>(A) CDKL1 的缺失促进 YBX1 与 PD-L1 <span style="color: black;">起步</span>子的结合,从而上调 PD-L1 的表达。这反过来又<span style="color: black;">引起</span>CD8 T细胞失活和随后的免疫逃逸,<span style="color: black;">最后</span>赋予对放射免疫治疗的耐药性。(B) CDKL1 与 YBX1 结合并<span style="color: black;">控制</span> YBX1 在 PD-L1 <span style="color: black;">起步</span>子上的<span style="color: black;">累积</span>,从而下调 PD-L1 的表达。PD-L1 表达的降低促进了 CD8 T 细胞的活化,<span style="color: black;">最后</span>使肺癌对放射免疫治疗<span style="color: black;">敏锐</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考资料:</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">https://jeccr.biomedcentral.com/articles/10.1186/s13046-024-03007-w</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">注:本文旨在介绍医学<span style="color: black;">科研</span><span style="color: black;">发展</span>,<span style="color: black;">不可</span><span style="color: black;">做为</span>治疗<span style="color: black;">方法</span>参考。如需<span style="color: black;">得到</span>健康<span style="color: black;">指点</span>,请至正规医院就诊。</p>
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