CD38

CD38
  • 文章类型: Journal Article
    细胞NAD+在静止条件下连续降解和合成。在哺乳动物中,NAD+的合成主要是由烟酰胺(Nam)启动的Nam磷酸核糖基转移酶,而聚(ADP-核糖)聚合酶1(PARP1)和2(PARP2),sirtuin1(SIRT1),CD38和含有1(SARM1)的无菌α和TIR基序参与NAD+分解。使用2H标记的Nam的通量分析,我们发现,当哺乳动物细胞在没有Nam的情况下培养时,细胞NAD+水平得以维持,NAD+分解被完全抑制。在Nam面前,NAD+分解率(RB)在PARP1、PARP2、SIRT1或SARM1缺失时没有显著变化,而CD38的稳定表达并没有增加RB。然而,与野生型细胞相比,PARP1缺失细胞中的RB高得多,其中PARP1活性被选择性抑制剂阻断。相比之下,与对照细胞相比,在特异性CD38抑制剂存在下,CD38过表达细胞中的RB要低得多。结果表明,PARP1缺失上调了其他NAD酶的活性,而CD38表达下调内源性NAD酶的活性,包括PARP1和PARP2。细胞NAD+分解的速率和产生的NAD+浓度可以保持在恒定水平。尽管NAD+降解酶表达发生变化,通过对NAD酶活性的补偿调节。
    Cellular NAD+ is continuously degraded and synthesized under resting conditions. In mammals, NAD+ synthesis is primarily initiated from nicotinamide (Nam) by Nam phosphoribosyltransferase, whereas poly(ADP-ribose) polymerase 1 (PARP1) and 2 (PARP2), sirtuin1 (SIRT1), CD38, and sterile alpha and TIR motif containing 1 (SARM1) are involved in NAD+ breakdown. Using flux analysis with 2H-labeled Nam, we found that when mammalian cells were cultured in the absence of Nam, cellular NAD+ levels were maintained and NAD+ breakdown was completely suppressed. In the presence of Nam, the rate of NAD+ breakdown (RB) did not significantly change upon PARP1, PARP2, SIRT1, or SARM1 deletion, whereas stable expression of CD38 did not increase RB. However, RB in PARP1-deleted cells was much higher compared with that in wild-type cells, in which PARP1 activity was blocked with a selective inhibitor. In contrast, RB in CD38-overexpressing cells in the presence of a specific CD38 inhibitor was much lower compared with that in control cells. The results indicate that PARP1 deletion upregulates the activity of other NADases, whereas CD38 expression downregulates the activity of endogenous NADases, including PARP1 and PARP2. The rate of cellular NAD+ breakdown and the resulting NAD+ concentration may be maintained at a constant level, despite changes in the NAD+-degrading enzyme expression, through the compensatory regulation of NADase activity.
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  • 文章类型: Journal Article
    环状ADP-核糖(cADPR)已成为平滑肌细胞中的钙调节第二信使。CD38蛋白具有ADP-核糖基环化酶和cADPR水解酶活性,并介导cADPR的合成和降解。我们先前已经表明,子宫肌层中CD38的表达受雌激素和孕激素的调节。考虑到妊娠期的荷尔蒙调节,本研究的目的是确定CD38/cADPR信号传导在使用永生化妊娠人类子宫肌层(PHM1)细胞刺激收缩激动剂后调节细胞内钙中的作用.蛋白质印迹,免疫荧光,生化研究证实了CD38的表达以及PHM1细胞膜上ADP-核糖基环化酶(2.6±0.1pmol/mg)和cADPR水解酶(26.8±6.8nmoles/mg/h)活性的存在。催产素,PGF2α,ET-1引起[Ca2+]i响应,和8-Br-cADPR,cADPR拮抗剂可显著减弱激动剂诱导的[Ca2+]i反应,平均在20%至46%之间。研究结果表明,子宫收缩激动剂部分通过CD38/cADPR信号传导来介导其作用,以增加[Ca2]i和可能的子宫收缩。由于人体研究受到健康供体子宫肌层的限制,PHM1细胞形成体外模型以研究人子宫肌层。
    Cyclic ADP-ribose (cADPR) has emerged as a calcium-regulating second messenger in smooth muscle cells. CD38 protein possesses ADP-ribosyl cyclase and cADPR hydrolase activities and mediates cADPR synthesis and degradation. We have previously shown that CD38 expression is regulated by estrogen and progesterone in the myometrium. Considering hormonal regulation in gestation, the objective of the present study was to determine the role of CD38/cADPR signaling in the regulation of intracellular calcium upon contractile agonist stimulation using immortalized pregnant human myometrial (PHM1) cells. Western blot, immunofluorescence, and biochemical studies confirmed CD38 expression and the presence of ADP-ribosyl cyclase (2.6 ± 0.1 pmol/mg) and cADPR hydrolase (26.8 ± 6.8 nmoles/mg/h) activities on the PHM1 cell membrane. Oxytocin, PGF2α, and ET-1 elicited [Ca2+]i responses, and 8-Br-cADPR, a cADPR antagonist significantly attenuated agonist-induced [Ca2+]i responses between 20% and 46% in average. The findings suggest that uterine contractile agonists mediate their effects in part through CD38/cADPR signaling to increase [Ca2+]i and presumably uterine contraction. As studies in humans are limited by the availability of myometrium from healthy donors, PHM1 cells form an in vitro model to study human myometrium.
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  • 文章类型: Journal Article
    牛皮癣是一种慢性,以免疫反应失调和全身性炎症为特征的炎症性皮肤病。多达三分之一的银屑病患者患有银屑病关节炎(PsA)。用中和肿瘤坏死因子(TNF)的抗体进行靶向治疗可以改善两种疾病。我们在这里探讨了长期英夫利昔单抗治疗对慢性皮肤和关节炎症中循环免疫细胞的组成和活性状态的影响。通过多色流式细胞术分析免疫细胞。我们测量了24例英夫利昔单抗治疗的银屑病/银屑病关节炎患者与32例健康对照的外周血单核细胞(PBMC)群体中免疫激活的标志物。与健康对照和银屑病患者相比,我们观察到PsA中外周自然杀伤(NK)细胞及其亚群CD56dimCD16NK细胞的频率显着降低。在这些患者中,后者与PASI有很强的正相关,而CD56brightCD16-NK细胞与PASI呈负相关。此外,我们观察到银屑病患者PsA中CD69+中间CD14+CD16+和CD69+经典CD14+CD16-单核细胞的上调和CD38+中间CD14+CD16+单核细胞的活性增加。与健康对照相比,银屑病患者表现出三个B细胞亚群的变化,过渡性CD27-CD38高B细胞的减少。我们的探索性研究表明,尽管接受英夫利昔单抗治疗的患者临床稳定,但病理生理过程仍保持不变,包括持续的全身性炎症。
    Psoriasis is a chronic, inflammatory skin disease characterized by a dysregulated immune response and systemic inflammation. Up to one-third of patients with psoriasis have psoriatic arthritis (PsA). Targeted treatment with antibodies neutralizing tumor necrosis factor (TNF) can ameliorate both diseases. We here explored the impact of long-term infliximab treatment on the composition and activity status of circulating immune cells involved in chronic skin and joint inflammation. Immune cells were analyzed by multicolor flow cytometry. We measured markers of immune activation in peripheral blood mononuclear cell (PBMC) populations in 24 infliximab-treated patients with psoriasis/psoriatic arthritis compared to 32 healthy controls. We observed a significant decrease in the frequency of both peripheral natural killer (NK) cells and their subset CD56dimCD16+ NK cells in PsA compared to healthy controls and patients with psoriasis. The latter had a strong positive correlation with PASI in these patients, while CD56brightCD16- NK cells were negatively correlated with PASI. In addition, we observed an upregulation of CD69+ intermediate CD14+CD16+ and CD69+ classical CD14+CD16- monocytes in PsA and increased activity of CD38+ intermediate CD14+CD16+ monocytes in patients with psoriasis. Compared to healthy controls, psoriasis patients demonstrated shifts of the three B cell subsets with a decrease in transitional CD27-CD38high B cells. Our exploratory study indicates a preserved pathophysiological process including continuous systemic inflammation despite clinical stability of the patients treated with infliximab.
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  • 文章类型: Journal Article
    高血压(HTN)影响了近一半的成年人,易患心血管疾病和肾损害。盐敏感性HTN(SSHTN)和血管紧张素II(A2)诱导的HTN(A2HTN)均涉及免疫系统激活和肾脏先天免疫细胞浸润。激活的[分化簇38(CD38)]先天免疫细胞亚群,如巨噬细胞和树突状细胞(DC),在调节肾功能和血压方面发挥不同的作用。目前尚不清楚这些细胞如何变成CD38+或哪些亚型是促高血压的。当骨髓来源的单核细胞(BMDM)在粒细胞-巨噬细胞集落刺激因子(GM-CSF)中生长并用盐或A2处理时,CD38巨噬细胞和CD38DC增加。GM-CSF引发的BMDM过继转移到具有SSHTN或A2HTN的小鼠中增加了肾CD38巨噬细胞和CD38DC。流式细胞术显示肾脏M1巨噬细胞和2型常规DC(cDC2s)增加,以及他们的CD38+同行,在具有SSHTN或A2HTN的小鼠中。这些结果在体外是可复制的。GM-CSF引发的BMDMs的盐或A2处理显着增加骨髓源性(BMD)-M1巨噬细胞,CD38+BMD-M1巨噬细胞,BMD-cDC2s,和CD38+BMD-cDC2s。总的来说,这些数据表明,GM-CSF是必需的盐或A2诱导CD38+先天免疫细胞,和CD38区分促高血压免疫细胞。对CD38M1巨噬细胞和CD38cDC2s的进一步研究可以为SSHTN和A2HTN提供新的治疗靶标。
    Hypertension (HTN) impacts almost half of adults, predisposing them to cardiovascular disease and renal damage. Salt-sensitive HTN (SSHTN) and angiotensin II (A2)-induced HTN (A2HTN) both involve immune system activation and renal innate immune cell infiltration. Subpopulations of activated [Cluster of differentiation 38 (CD38)] innate immune cells, such as macrophages and dendritic cells (DCs), play distinct roles in modulating renal function and blood pressure. It is unknown how these cells become CD38+ or which subtypes are pro-hypertensive. When bone marrow-derived monocytes (BMDMs) were grown in granulocyte-macrophage colony stimulating factor (GM-CSF) and treated with salt or A2, CD38+ macrophages and CD38+ DCs increased. The adoptive transfer of GM-CSF-primed BMDMs into mice with either SSHTN or A2HTN increased renal CD38+ macrophages and CD38+ DCs. Flow cytometry revealed increased renal M1 macrophages and type-2 conventional DCs (cDC2s), along with their CD38+ counterparts, in mice with either SSHTN or A2HTN. These results were replicable in vitro. Either salt or A2 treatment of GM-CSF-primed BMDMs significantly increased bone marrow-derived (BMD)-M1 macrophages, CD38+ BMD-M1 macrophages, BMD-cDC2s, and CD38+ BMD-cDC2s. Overall, these data suggest that GM-CSF is necessary for the salt or A2 induction of CD38+ innate immune cells, and that CD38 distinguishes pro-hypertensive immune cells. Further investigation of CD38+ M1 macrophages and CD38+ cDC2s could provide new therapeutic targets for both SSHTN and A2HTN.
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  • 文章类型: Journal Article
    我们进行了一个小的,开放标签,daratumumab探索目标参与的初步研究,安全,轻度至中度阿尔茨海默病患者的潜在疗效。DaratumumabSC1800mg每周皮下给药8周,然后每2周进行16周。流式细胞术测量CD8+CD4-T细胞的CD38+比例,并在基线进行认知评估,第176天和第246天。Daratumumab在24周后显著减少CD38+CD8+CD4-T细胞,并且这种效果在此后持续11周。没有血液学毒性或意外的不良事件。响应者分析显示认知结果指标没有改善。
    We conducted a small, open-label, pilot study of daratumumab to explore target engagement, safety, and potential efficacy in patients with mild to moderate Alzheimer\'s disease. Daratumumab SC 1800 mg was given subcutaneously weekly for 8 weeks, then every 2 weeks for 16 weeks. Flow cytometry to measure the CD38+ proportion of CD8 + CD4- T cells and cognitive assessments were performed at baseline, day 176, and day 246. Daratumumab significantly reduced CD38 + CD8 + CD4- T cells after 24 weeks and this effect persisted 11 weeks thereafter. There was no hematological toxicity or unexpected adverse events. Responder analysis showed no improvement on cognitive outcome measures.
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  • 文章类型: Case Reports
    多发性骨髓瘤(MM)是世界上公认的骨髓(BM)癌症之一。它被认为是浆细胞异常,其中正常浆细胞转化为恶性细胞,产生大量异常免疫球蛋白,称为单克隆蛋白,通常称为M蛋白。这个,反过来,与骨骼和肾脏有关的许多表现。许多易位与疾病有关,例如t(11;14),t(4;14),和t(14;16)。其中,最常见的是t(11;14)。在MM的这个子集中,有一个特定的遗传改变影响CCND1基因。通常在浆细胞中不活跃,这个基因,当中断时,促进不受控制的细胞增殖。同时,CD38水平下降了,一种在MM患者中通常升高的蛋白质。遗传和蛋白质表达的这种组合是MM谱内这个亚组的定义特征。在这份报告中,我们介绍了一例75岁男性患者,该患者被肿瘤科医师转诊接受综合诊断检测.发现他具有明显的超倍体,涉及9三体和CCND1的额外拷贝,并伴随着11q三体,证实了t(11;14)易位。涉及细胞学的进一步检查显示,患者也表达了升高的CD38水平,鉴于这种突变,预计在这个患者群体中会很低。我们的目标是强调这种突变的重要性和预后价值,并进一步增加与这种疾病相关的文献。
    Multiple myeloma (MM) is one of the world\'s most recognized bone marrow (BM) cancers. It is considered a plasma cell dyscrasia in which normal plasma cells transform into malignant cells that produce large quantities of an abnormal immunoglobulin called monoclonal protein better known as M protein. This, in turn, is responsible for many of its bone and kidney-related manifestations. Many translocations are associated with the disease, such as t(11;14), t(4;14), and t(14;16). Of these, the most common is t(11;14). In this subset of MM, there is a specific genetic alteration affecting the CCND1 gene. Typically inactive in plasma cells, this gene, when disrupted, promotes uncontrolled cell proliferation. Simultaneously, there is a reduction in CD38 levels, a protein typically elevated in MM patients. This combination of genetic and protein expression is a defining feature of this subgroup within the MM spectrum. In this report, we present a case of a 75-year-old male who was referred by an oncologist for comprehensive diagnostic testing. He was found to have significant hyperploidy involving trisomy 9 and an extra copy of CCND1 with concomitant trisomy 11q confirming a t(11;14) translocation. Further workup involving cytology revealed that the patient also expressed elevated levels of CD38, which, given this mutation, would be expected to be low in this patient population. We aim to highlight the importance and prognostic value of this mutation and further add to the already growing body of literature associated with this disease.
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  • 文章类型: Journal Article
    目的:认知损害,尤其是受损的社会认知,是精神分裂症(SZ)患者社交生活恶化的主要原因。催产素(OT)是一种神经肽,为SZ提供了有希望的治疗方法。本研究旨在探讨OT是否会影响地佐西平(MK801)引起的认知功能障碍,并探讨外源性OT对海马内源性OT系统的影响。
    方法:采用地佐西平[MK801,0.6mg/kg,腹膜内(i.p.)],然后是OT(6-60μg/kg,鼻内)或利培酮(0.3mg/kg,i.p.)用于探讨OT对认知障碍的影响。
    结果:在6μg/kg剂量下的OT减轻了MK801引起的多动症,社交能力受损,和空间记忆障碍。剂量为20或60μg/kg的OT可以减轻多动症和社交新颖性损害。在注射MK801的小鼠中,三种OT剂量逆转了海马中OTmRNA的代偿性上调,而60μg/kgOT逆转了CD38蛋白表达的代偿性上调。
    结论:OT对SZ小鼠模型的认知障碍有不同程度的缓解,逆转海马中OT信号的代偿性上调。
    OBJECTIVE: Cognitive impairment, especially impaired social cognition, is largely responsible for the deterioration of the social life of patients with schizophrenia (SZ). Oxytocin (OT) is a neuropeptide that offers promising therapy for SZ. This study aimed to explore whether OT could affect dizocilpine (MK801)-induced cognitive impairment and to investigate the effect of exogenous OT on the endogenous OT system in the hippocampus.
    METHODS: The SZ mouse model was established by repeated administration of dizocilpine [MK801, 0.6 mg/kg, intraperitoneal (i.p.)], and then OT (6-60 μg/kg, intranasal) or risperidone (0.3 mg/kg, i.p.) was administered to explore the effect of OT on cognitive impairment.
    RESULTS: OT at a dose of 6 μg/kg alleviated MK801-induced hyperactivity, sociability impairment, and spatial memory impairment. OT at a dose of 20 or 60 μg/kg attenuated the hyperactivity and social novelty impairment. In MK801-injected mice, the compensatory upregulation of OT mRNA in the hippocampus was reversed by three OT doses, whereas 60 μg/kg OT reversed the compensatory upregulation of CD38 protein expression.
    CONCLUSIONS: OT alleviated cognitive impairment in the SZ mouse model to varying degrees, reversing the compensatory upregulation of OT signaling in the hippocampus.
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  • 文章类型: Journal Article
    复发/难治性急性白血病(R/R-AL)与低缓解率相关,短存活率,预后不良。治疗R/R-AL仍然具有挑战性,因为没有标准化的有效方案;因此,需要有效的治疗方法。已经在急性髓性白血病(AML)和急性淋巴细胞白血病(ALL)中观察到CD38表达。Daratumumab是一种人源化抗CD38单克隆抗体,用于治疗多发性骨髓瘤,据报道可安全有效地治疗R/R-AL。回顾性分析2018年7月至2023年5月在我中心接受基于达拉图单抗的抢救方案治疗的10例成人R/R-AL患者的临床资料。分析中包括7例AML和3例ALL病例。7名(70%)患者对治疗有反应(完全反应[CR],60%;部分响应[PR],10%)。在七个响应者中,三人接受了同种异体干细胞移植(ASCT),包括接受第二次ASCT的人。在5例之前接触过维奈托克的R/R型AML患者中,当维奈托克联合达雷妥单抗再次治疗时,3例患者获得治疗应答(2例CR和1例PR).中位随访时间为6.15个月(0.9~21个月)。12个月的总生存率和无事件生存率分别为68.6%和40.0%,分别。主要不良事件包括3级发热性中性粒细胞减少(20%)和3级血液学毒性(60%)。基于达雷妥单抗的救助方案为R/R-AL患者提供了缓解的机会,并具有可接受的耐受性,创建桥接ASCT的可能性。
    Relapsed/refractory acute leukemia (R/R-AL) is associated with a low remission rate, short survival rate, and poor prognosis. Treating R/R-AL remains challenging as there is no standardized effective regimen; hence, there is a need for efficient therapies. CD38 expression has been observed in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Daratumumab is a humanized anti-CD38 monoclonal antibody used to treat multiple myeloma and has been reported to treat R/R-AL safely and effectively. The clinical data of 10 adult patients with R/R-AL who were treated with a daratumumab-based salvage regimen between July 2018 and May 2023 at our center were analyzed retrospectively. Seven AML and three ALL cases were included in the analysis. Seven (70%) patients showed responses to the treatments (complete response [CR], 60%; partial response [PR], 10%). Of the seven responders, three underwent allogenic stem cell transplantation (ASCT), including one who underwent a second ASCT. Among the five patients with R/R AML who had prior exposure to venetoclax, three achieved a therapeutic response (two CR and one PR) when re-treated with venetoclax in combination with daratumumab. The median follow-up time was 6.15 months (0.9-21 months). Overall survival and event-free survival rates at 12 months were 68.6% and 40.0%, respectively. The main adverse events included grade 3 febrile neutropenia (20%) and grade 3 hematological toxicities (60%). The daratumumab-based salvage regimen offers patients with R/R-AL the opportunity of remission with acceptable tolerability, creating the possibility of bridging ASCT.
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  • 文章类型: Journal Article
    全反式维甲酸(ATRA)在组织发育中起作用,神经功能,繁殖,愿景,细胞生长和分化,肿瘤免疫,和凋亡。ATRA可以通过诱导自噬信号发挥作用,血管生成,细胞分化,凋亡,和免疫功能。在血液系统中,ATRA首次用于急性早幼粒细胞白血病(APL),ATRA将白血病细胞分化为成熟粒细胞。ATRA不仅可以在APL中发挥作用,但也可能在其他血液病中发挥作用,如免疫性血小板减少症(ITP),骨髓增生异常综合征(MDS),非APL急性髓系白血病(AML),再生障碍性贫血(AA),多发性骨髓瘤(MM),等。,特别是通过调节间充质干细胞和调节性T细胞来治疗ITP。ATRA还可以增加肿瘤细胞表达的CD38的表达,从而提高达雷妥单抗和CD38-CART的疗效。在这次审查中,我们关注ATRA的作用机制,它在各种血液病中的作用,药物组合,和正在进行的临床试验。
    All-trans retinoic acid (ATRA) plays a role in tissue development, neural function, reproduction, vision, cell growth and differentiation, tumor immunity, and apoptosis. ATRA can act by inducing autophagic signaling, angiogenesis, cell differentiation, apoptosis, and immune function. In the blood system ATRA was first used with great success in acute promyelocytic leukemia (APL), where ATRA differentiated leukemia cells into mature granulocytes. ATRA can play a role not only in APL, but may also play a role in other hematologic diseases such as immune thrombocytopenia (ITP), myelodysplastic syndromes (MDS), non-APL acute myeloid leukemia (AML), aplastic anemia (AA), multiple myeloma (MM), etc., especially by regulating mesenchymal stem cells and regulatory T cells for the treatment of ITP. ATRA can also increase the expression of CD38 expressed by tumor cells, thus improving the efficacy of daratumumab and CD38-CART. In this review, we focus on the mechanism of action of ATRA, its role in various hematologic diseases, drug combinations, and ongoing clinical trials.
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  • 文章类型: Journal Article
    慢性淋巴细胞白血病(CLL)是一种异质性疾病,其特征是肿瘤性CD5/CD19B淋巴细胞的积累。白血病的传播依赖于CLL细胞在血液中存活并迁移到骨髓和淋巴组织中并在其中增殖的能力。一些CLL患者要么对目前可用的疗法难以治疗,要么在治疗后复发;这强调了对改善临床反应并克服耐药性的新型治疗策略的需求。CD38是预后不良的标志,并控制着一组生存,促进CLL病理生理学的增殖和迁移信号。文献数据证明CD38的细胞表面表达与其他CLL抗原的细胞表面表达之间存在时空关联,如B细胞受体(BCR),CD19,CD26,CD44,整合素极晚期抗原4(VLA4),趋化因子受体CXCR4,血管内皮生长因子受体2(VEGF-R2),和中性粒细胞明胶酶相关脂质运载蛋白受体(NGAL-R)。这些蛋白质中的大多数有助于CLL细胞的存活,扩散和贩运,并在多层信号转导过程中与CD38合作。总的来说,这些抗原已经被验证为癌症的治疗靶点,和广泛的特异性单克隆抗体和衍生物是可用的。这里,我们回顾了该领域的最新技术,并研究了联合靶向CD38及其合作伙伴在CLL中的治疗机会,例如通过设计新型双/三特异性抗体。
    Chronic lymphocytic leukaemia (CLL) is a heterogenous disease characterized by the accumulation of neoplastic CD5+/CD19+ B lymphocytes. The spreading of the leukaemia relies on the CLL cell\'s ability to survive in the blood and migrate to and proliferate within the bone marrow and lymphoid tissues. Some patients with CLL are either refractory to the currently available therapies or relapse after treatment; this emphasizes the need for novel therapeutic strategies that improving clinical responses and overcome drug resistance. CD38 is a marker of a poor prognosis and governs a set of survival, proliferation and migration signals that contribute to the pathophysiology of CLL. The literature data evidence a spatiotemporal association between the cell surface expression of CD38 and that of other CLL antigens, such as the B-cell receptor (BCR), CD19, CD26, CD44, the integrin very late antigen 4 (VLA4), the chemokine receptor CXCR4, the vascular endothelial growth factor receptor-2 (VEGF-R2), and the neutrophil gelatinase-associated lipocalin receptor (NGAL-R). Most of these proteins contribute to CLL cell survival, proliferation and trafficking, and cooperate with CD38 in multilayered signal transduction processes. In general, these antigens have already been validated as therapeutic targets in cancer, and a broad repertoire of specific monoclonal antibodies and derivatives are available. Here, we review the state of the art in this field and examine the therapeutic opportunities for cotargeting CD38 and its partners in CLL, e.g. by designing novel bi-/trispecific antibodies.
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