pd-l1

PD - L1
  • 文章类型: Journal Article
    外泌体,它们是纳米级的细胞外囊泡,已经成为肿瘤细胞和免疫系统之间串扰的关键介质。细胞间粘附分子1(ICAM1)在多种免疫功能的发生中起着至关重要的作用,癌症的发展和转移。作为一种在细胞膜上表达的糖蛋白,ICAM1在胞外体上分泌并调节免疫抑制微环境。然而,外泌体ICAM1在乳腺癌骨转移免疫微环境中的作用尚不清楚.这项研究旨在阐明外泌体ICAM1在三阴性乳腺癌(TNBC)中促进CD8T细胞耗竭和随后的骨转移中的作用。我们证明了TNBC细胞释放富含ICAM1的外泌体,ICAM1与其受体的结合是CD8T细胞增殖和功能抑制作用所必需的。这种关键的参与不仅抑制CD8+T细胞增殖和活化,而且还启动有助于TNBC肿瘤生长和骨转移的免疫抑制微环境的发展。此外,ICAM1阻断显着损害肿瘤外泌体结合CD8+T细胞的能力,从而抑制其免疫抑制作用。本研究阐明了由外泌体介导的原发性肿瘤与免疫系统之间的复杂相互作用,并为开发靶向ICAM1以减轻TNBC骨转移的新型癌症免疫疗法奠定了基础。
    Exosomes, which are nanosized extracellular vesicles, have emerged as crucial mediators of the crosstalk between tumor cells and the immune system. Intercellular adhesion molecule 1 (ICAM1) plays a crucial role in multiple immune functions as well as in the occurrence, development and metastasis of cancer. As a glycoprotein expressed on the cell membrane, ICAM1 is secreted extracellularly on exosomes and regulates the immunosuppressive microenvironment. However, the role of exosomal ICAM1 in the immune microenvironment of breast cancer bone metastases remains unclear. This study aimed to elucidated the role of exosomal ICAM1 in facilitating CD8+ T cell exhaustion and subsequent bone metastasis in triple-negative breast cancer (TNBC). We demonstrated that TNBC cells release ICAM1-enriched exosomes, and the binding of ICAM1 to its receptor is necessary for the suppressive effect of CD8 T cell proliferation and function. This pivotal engagement not only inhibits CD8+ T cell proliferation and activation but also initiates the development of an immunosuppressive microenvironment that is conducive to TNBC tumor growth and bone metastasis. Moreover, ICAM1 blockade significantly impairs the ability of tumor exosomes to bind to CD8+ T cells, thereby inhibiting their immunosuppressive effects. The present study elucidates the complex interaction between primary tumors and the immune system that is mediated by exosomes and provides a foundation for the development of novel cancer immunotherapies that target ICAM1 with the aim of mitigating TNBC bone metastasis.
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  • 文章类型: Journal Article
    奥沙利铂目前用于肝细胞癌患者的化疗,但随着时间的推移,它对肿瘤的耐受性增加限制了它的临床应用。研究表明,PD-L1高表达促进M2巨噬细胞的极化。M2巨噬细胞浸润增加,包括HCC中的那些,与各种实体瘤的不良预后呈正相关。我们发现奥沙利铂促进肝癌细胞PD-L1的表达,这可能部分归因于肿瘤对奥沙利铂的耐受性。因此,在这项研究中,我们通过免疫印迹法探讨了携带siRNA-PD-L1的减毒沙门氏菌联合奥沙利铂的抗肿瘤作用,免疫组织化学,免疫荧光,和流式细胞术。结果表明,减毒沙门氏菌携带siRNA-PD-L1联合奥沙利铂更显著地抑制荷瘤小鼠的肿瘤生长,抑制PD-L1在肿瘤组织中的表达,增加肿瘤细胞的凋亡和肿瘤相关蛋白cleaved-caspase3的表达,并增加肿瘤组织中M1巨噬细胞和T淋巴细胞的浸润。此外,联合疗法增加了小鼠脾脏中T细胞的活化以及T淋巴细胞和NK细胞的数量,并改善了小鼠的整体抗肿瘤免疫反应。我们的研究结果证实,携带siRNA-PD-L1的减毒沙门氏菌联合奥沙利铂具有显著的抗肿瘤作用,并且没有增加毒副作用的发生率。为解决奥沙利铂治疗肝癌的耐受性提供理论参考。
    Oxaliplatin is currently used for chemotherapy in patients with hepatocellular carcinoma, but its increasing tolerance to tumours over time limits its clinical application. Studies have shown that high PD-L1 expression promotes the polarization of M2 macrophages. The increased infiltration of M2 macrophages, including those in HCC, is positively correlated with poor prognosis in various solid tumours. We found that oxaliplatin promoted the expression of PD-L1 in liver cancer cells, which might be attributed partly to the tolerance of tumours to oxaliplatin. Therefore, in this study, we explored the antitumour effect of attenuated Salmonella carrying siRNA-PD-L1 combined with oxaliplatin via Western blotting, immunohistochemistry, immunofluorescence, and flow cytometry. The results revealed that attenuated Salmonella carrying siRNA-PD-L1 combined with oxaliplatin more significantly inhibited tumour growth in tumour-bearing mice, suppressed the expression of PD-L1 in tumour tissue, increased the apoptosis of tumour cells and the expression of the tumour-related protein cleaved-caspase3, and increased the infiltration of M1 macrophages and T lymphocytes in tumour tissues. Moreover, the combination therapy increased the activation of T cells and the number of T lymphocytes and NK cells in the spleens of the mice and improved the overall antitumour immune response in the mice. Our results confirmed that attenuated Salmonella harbouring siRNA-PD-L1 combined with oxaliplatin had a significant antitumour effect and did not increase the incidence of toxic side effects, providing a theoretical reference for addressing oxaliplatin tolerance in the treatment of hepatocellular carcinoma.
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  • 文章类型: Journal Article
    背景:肝细胞癌(HCC)是一种常见的致命癌症,预后不良。Obovatol(Ob),一种新颖的木兰木兰的叶和茎皮衍生的木脂素,对多种肿瘤均有抗肿瘤作用。然而,其对肝癌的作用及机制有待进一步探讨。
    方法:Huh7和Hep3B细胞,以及BALB/c裸鼠用于确定Ob对生长的功能和机制,通过细胞计数试剂盒-8,transwell,酶联免疫吸附测定(ELISA)和蛋白质印迹实验。
    结果:Ob降低了Huh7和Hep3B细胞的细胞活力,IC50值为57.41µM和62.86µM,分别。Ob下降了入侵能力,N-cadherin的蛋白表达和IL-10和TGF-β的浓度,而增加了Hep3B和Huh7细胞中E-cadherin的表达以及IFN-γ和IL-2的含量。机械上,Ob降低了p-JAK/JAK的蛋白质水平,p-STAT3/STAT3和PD-L1,随着JAK/STAT3轴激活剂RO8191的治疗而部分恢复。Ob对细胞活力的影响,入侵能力,N-cadherin和E-cadherin的蛋白质水平,以及IL-10,TGF-β,在RO8191的处理下,Hep3B和Huh7细胞中的IFN-γ和IL-2被逆转。在体内,Ob减少肿瘤体积和重量,N-钙黏着蛋白的水平,PD-L1,p-JAK/JAK,和p-STAT3/STAT3,E-钙粘蛋白和IFN-γ的表达升高。
    结论:Ob下调JAK/STST3/PD-L1途径以减弱生长,肝癌的侵袭和免疫逃逸。
    BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer that is fatal and has a dismal prognosis. Obovatol (Ob), a novel lignan derived from the leaf and stem bark of Magnolia obovata Thunb, has exhibited anti-tumor effect on diverse tumors. However, its effect and mechanisms on HCC remain to be further explored.
    METHODS: Huh7 and Hep3B cells, as well as BALB/c nude mice were used to determine the function and mechanisms of Ob on growth, invasion and immune escape by cell counting kit-8, transwell, enzyme-linked immunosorbent assay (ELISA) and western blot experiments.
    RESULTS: Ob reduced the cell viability of Huh7 and Hep3B cells, with a IC50 value of 57.41 µM and 62.86 µM, respectively. Ob declined the invasion ability, the protein expression of N-cadherin and the concentrations of IL-10 and TGF-β, whereas increased the E-cadherin expression and the contents of IFN-γ and IL-2 in Hep3B and Huh7 cells. Mechanically, Ob decreased the protein level of p-JAK/JAK, p-STAT3/STAT3 and PD-L1, which was partly restored with the treatment of RO8191, an activator of JAK/STAT3 axis. The effect of Ob on the cell viability, the invasion ability, the protein level of N-cadherin and E-cadherin, and the concentrations of IL-10, TGF-β, IFN-γ and IL-2 in both Hep3B and Huh7 cells was reversed with the management of RO8191. In vivo, Ob reduced tumor volume and weight, the level of N-cadherin, PD-L1, p-JAK/JAK, and p-STAT3/STAT3, with an elevated expression of E-cadherin and IFN-γ.
    CONCLUSIONS: Ob downregulated the JAK/STST3/PD-L1 pathway to attenuate the growth, invasion and immune escape of HCC.
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  • 文章类型: Journal Article
    胆道癌(BTC)的发病率和死亡率不断上升。化疗的有限疗效导致探索新的治疗方法,如免疫疗法。这提供了适度的好处。此外,用于BTC免疫检查点治疗的可靠预测性生物标志物的鉴定仍然难以捉摸,阻碍个性化治疗策略。这篇综述概述了BTC免疫治疗反应的新兴生物标志物的现状。我们讨论了联合治疗的增量益处以及免疫治疗在管理晚期BTC中的不断发展的作用。此外,我们强调需要稳健的预测性生物标志物来优化治疗结果,并促进更个性化的患者护理方法.我们的目标是确定有希望的研究途径和策略,以提高BTC的治疗效果和患者生存率。
    [方框:见正文]。
    Biliary tract cancers (BTCs) have rising incidence and mortality rates. Chemotherapy\'s limited efficacy has led to exploring new treatments like immunotherapy. which offers modest benefits. Moreover, the identification of reliable predictive biomarkers for immune checkpoint therapy in BTCs remains elusive, hindering personalized treatment strategies. This review provides an overview of the current landscape of emerging biomarkers for immunotherapy response in BTCs. We discuss the incremental benefits of combination therapy and the evolving role of immunotherapy in managing advanced BTC. Additionally, we highlight the need for robust predictive biomarkers to optimize treatment outcomes and foster a more individualized approach to patient care. We aim to identify promising research avenues and strategies to enhance therapeutic efficacy and patient survival in BTCs.
    [Box: see text].
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  • 文章类型: Journal Article
    目的:使用PD-L1阻断的免疫治疗仅对一小部分癌症患者有效,抵抗是常见的。这强调了了解癌症免疫逃避和抵抗机制的重要性。
    方法:基因组规模的CRISPR-Cas9筛选将Bap1鉴定为PD-L1表达的调节因子。为了测量肿瘤大小和存活率,将肿瘤细胞皮下注射到同基因WT小鼠和免疫受损小鼠中。使用流式细胞术检查Bap1缺失肿瘤的表型和转录特征,RNA-seq,以及CUT和Tag-seq分析。
    结果:我们发现癌细胞中组蛋白去泛素酶Bap1的丢失激活了cDC1-CD8+T细胞依赖性抗肿瘤免疫。Bap1的缺失导致与抗肿瘤免疫应答相关的基因增加和与免疫逃避相关的基因减少。因此,肿瘤微环境发炎,更多的cDC1细胞和效应CD8+T细胞,但中性粒细胞和调节性T细胞较少。我们还发现,Bap1缺失肿瘤的消除取决于肿瘤MHCI分子和Fas介导的CD8T细胞毒性。我们对TCGA数据的分析进一步支持了这些发现,显示在各种人类癌症中BAP1表达和活化DC的mRNA签名与T细胞的细胞毒性之间的反向相关性。
    结论:组蛋白去泛素酶Bap1可用作肿瘤分层的生物标志物,并作为癌症免疫治疗的潜在治疗靶点。
    OBJECTIVE: Immunotherapy using PD-L1 blockade is effective in only a small group of cancer patients, and resistance is common. This emphasizes the importance of understanding the mechanisms of cancer immune evasion and resistance.
    METHODS: A genome-scale CRISPR-Cas9 screen identified Bap1 as a regulator of PD-L1 expression. To measure tumor size and survival, tumor cells were subcutaneously injected into both syngeneic WT mice and immunocompromised mice. The phenotypic and transcriptional characteristics of Bap1-deleted tumors were examined using flow cytometry, RNA-seq, and CUT&Tag-seq analysis.
    RESULTS: We found that loss of histone deubiquitinase Bap1 in cancer cells activates a cDC1-CD8+ T cell-dependent anti-tumor immunity. The absence of Bap1 leads to an increase in genes associated with anti-tumor immune response and a decrease in genes related to immune evasion. As a result, the tumor microenvironment becomes inflamed, with more cDC1 cells and effector CD8+ T cells, but fewer neutrophils and regulatory T cells. We also found that the elimination of Bap1-deleted tumors depends on the tumor MHCI molecule and Fas-mediated CD8+ T cell cytotoxicity. Our analysis of TCGA data further supports these findings, showing a reverse correlation between BAP1 expression and mRNA signatures of activated DCs and T-cell cytotoxicity in various human cancers.
    CONCLUSIONS: The histone deubiquitinase Bap1 could be used as a biomarker for tumor stratification and as a potential therapeutic target for cancer immunotherapies.
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  • 文章类型: Journal Article
    免疫检查点阻断治疗在几种类型的肿瘤中取得了重要的临床进展,特别是通过靶向PD-1/PD-L1轴。然而,抑制PD-1/PD-L1信号通路的现有治疗策略通常具有低疗效和引起自身免疫性疾病的风险.在这里,我们报道了一种癌细胞靶向分子印迹溶酶体纳米降解剂(MILND),用于增强针对肿瘤的免疫检查点阻断治疗.MILND,用PD-L1的N端表位作为印迹模板,可以特异性靶向肿瘤细胞上的PD-L1以促进细胞摄取。这个过程进一步诱导PD-L1转运到溶酶体中进行降解,最终导致肿瘤细胞PD-L1表达水平下调。因此,通过阻断PD-1/PD-L1信号通路激活体内T细胞介导的免疫反应,这引发了持久的抗肿瘤功效。体内实验表明,MILND可以有效地积累在肿瘤部位,并在异种移植肿瘤模型中表现出强的肿瘤生长抑制作用,而没有明显的副作用。因此,MILND不仅为促进癌症免疫疗法提供了有希望的策略,还为开发分子印迹增强纳米药物提供了见解.
    Immune checkpoint blockade therapy has achieved important clinical advances in several types of tumors, particularly via targeting the PD-1/PD-L1 axis. However, existing therapeutic strategies that suppress the PD-1/PD-L1 signal pathway usually experience low treatment efficacy and the risk of causing autoimmune diseases. Herein, we report a cancer cell-targeted molecularly imprinted lysosomal nanodegrader (MILND) for boosting immune checkpoint blockade therapy against tumors. The MILND, imprinted with the N-terminal epitope of PD-L1 as an imprinting template, could specifically target the PD-L1 on tumor cells to promote cellular uptake. This process further induces the transport of PD-L1 into lysosomes for degradation, ultimately resulting in the downregulation of PD-L1 expression levels on tumor cells. As a result, a T cell-mediated immune response in the body was activated via the blockade of the PD-1/PD-L1 signaling pathway, which triggered a durable antitumor efficacy. In vivo experiments demonstrated that the MILND could effectively accumulate in tumor sites and exhibit strong tumor growth suppression efficacy in a xenograft tumor model without obvious side effects. Therefore, the MILND provides not only a promising strategy for boosting cancer immunotherapy but also insights for developing molecular imprinting-empowered nanomedicines.
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  • 文章类型: Journal Article
    背景:长链非编码RNA(LncRNA)被认为是癌症肿瘤发生和发展的关键调节因子。然而,它们在结直肠癌(CRC)中的功能和分子机制仍有待进一步阐明.
    方法:LINC00460通过人CRC和正常组织之间的差异分析进行鉴定,并通过原位杂交(ISH)和qRT-PCR进行验证。我们通过体外和体内实验研究了LINC00460在CRC中的生物学功能。我们通过生物信息学分析预测了LINC00460的作用机制和下游功能分子,并通过双荧光素酶报告基因测定证实了它们,RNA免疫沉淀(RIP),RNA下拉,等。结果:发现LINC00460在CRC中显著过表达,并与不良预后相关。过表达LINC00460促进CRC细胞免疫逃逸,重塑抑制性肿瘤免疫微环境,从而促进CRC增殖和转移。机制研究表明,LINC00460作为miR-186-3p的分子海绵,然后提升了MYC的表达式,CD47和PD-L1促进CRC细胞免疫逃逸。我们还证明MYC在转录水平上调LINC00460表达并形成正反馈环。
    结论:LINC00460/miR-186-3p/MYC反馈环促进CRC细胞免疫逃逸,进而促进CRC增殖和转移。我们的发现为LINC00460作为CRC免疫调节剂提供了新的见解,并为CRC患者提供潜在的治疗靶点。
    BACKGROUND: Long non-coding RNAs (LncRNAs) have been implicated as critical regulators of cancer tumorigenesis and progression. However, their functions and molecular mechanisms in colorectal cancer (CRC) still remain to be further elucidated.
    METHODS: LINC00460 was identified by differential analysis between human CRC and normal tissues and verified by in situ hybridization (ISH) and qRT-PCR. We investigated the biological functions of LINC00460 in CRC by in vitro and in vivo experiments. We predicted the mechanism and downstream functional molecules of LINC00460 by bioinformatics analysis, and confirmed them by dual luciferase reporter gene assay, RNA immunoprecipitation (RIP), RNA pull-down, etc. RESULTS: LINC00460 was found to be significantly overexpressed in CRC and associated with poor prognosis. Overexpression of LINC00460 promoted CRC cell immune escape and remodeled a suppressive tumor immune microenvironment, thereby promoting CRC proliferation and metastasis. Mechanistic studies showed that LINC00460 served as a molecular sponge for miR-186-3p, and then promoted the expressions of MYC, CD47 and PD-L1 to facilitate CRC cell immune escape. We also demonstrated that MYC upregulated LINC00460 expression at the transcriptional level and formed a positive feedback loop.
    CONCLUSIONS: The LINC00460/miR-186-3p/MYC feedback loop promotes CRC cell immune escape and subsequently facilitates CRC proliferation and metastasis. Our findings provide novel insight into LINC00460 as a CRC immune regulator, and provide a potential therapeutic target for CRC patients.
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  • 文章类型: Journal Article
    各种炎症标志物,包括中性粒细胞与淋巴细胞比率(NLR),单核细胞与淋巴细胞比率(MLR),血小板与淋巴细胞比率(PLR),和C反应蛋白与白蛋白的比率(CAR),已与免疫疗法在多种类型的恶性肿瘤中的有效性有关。我们调查了这些炎症标志物如何影响接受免疫治疗的头颈部鳞状细胞癌(HNSCC)患者的预后。
    数据库PubMed,Embase,和Cochrane进行了系统搜索,直到2024年3月26日,以确定相关文献。从符合条件的研究中提取危险比(HR)和相应的95%置信区间(CI)。使用ReviewManager和STATA17.0软件进行数据分析,以评估各指标对预后的影响。进行亚组分析以探索数据中异质性的潜在来源。
    分析包括16项研究,共1316名患者。较高的基线NLR与较差的总生存期(OS)(合并HR:1.55,95CI:1.14-2.11,P=0.006)和无进展生存期(PFS)(合并HR:1.59,95%CI:1.21-2.10,P<0.05)显著相关。此外,免疫治疗后高NLR与不良OS密切相关(合并HR:5.43,95%CI:3.63-8.12,P<0.01).此外,较高的基线C反应性CAR与较差的OS显著相关(合并HR:2.58,95%CI:1.96-3.40,P<0.01).
    炎症标志物NLR和CAR可作为HNSCC患者免疫治疗的有效预后生物标志物。然而,临床检测的实际应用需要通过大规模前瞻性研究进一步验证,以证实这些发现并探索潜在机制.
    UNASSIGNED: Various inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-albumin ratio (CAR), have been linked to the effectiveness of immunotherapy in multiple types of malignancies. We investigated how these inflammatory markers affect the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) receiving immunotherapy.
    UNASSIGNED: The databases PubMed, Embase, and Cochrane were systematically searched up until March 26, 2024, to identify relevant literature. Hazard ratios (HR) and corresponding 95% confidence intervals (CI) were extracted from the eligible studies. Data analysis was conducted using Review Manager and STATA 17.0 software to assess the impact of each indicator on prognosis. Subgroup analysis was performed to explore potential sources of heterogeneity in the data.
    UNASSIGNED: The analysis included sixteen studies with 1316 patients. A higher baseline NLR was significantly associated with poorer overall survival (OS) (pooled HR: 1.55, 95%CI: 1.14-2.11, P=0.006) and progression-free survival (PFS) (pooled HR: 1.59, 95% CI: 1.21-2.10, P<0.05). Furthermore, a high NLR after immunotherapy was strongly correlated with poor OS (pooled HR: 5.43, 95% CI: 3.63-8.12, P<0.01). Additionally, higher baseline C-reactive CAR was significantly associated with worse OS (pooled HR: 2.58, 95% CI: 1.96-3.40, P<0.01).
    UNASSIGNED: The inflammatory markers NLR and CAR serve as effective prognostic biomarkers for immunotherapy in patients with HNSCC. However, the practical application of clinical detection requires further validation through large-scale prospective studies to confirm these findings and explore the underlying mechanisms.
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  • 文章类型: Journal Article
    免疫检查点抑制剂治疗会导致许多与免疫相关的不良事件,包括自身免疫性胰腺损伤(AIPI),导致器官迅速萎缩.我们分析了临床放射学特征,短期自然史,以及对AIPI类固醇的反应。
    我们回顾性回顾了229/11,165(2.1%)AIPI成年患者的医疗记录。229人中有一百一十(48%)在脂肪酶升高时进行了腹部计算机断层扫描(CT)扫描;分析了110例没有胰腺转移的数据。我们分析了48例AIPI患者(32例正常CT和16例脂肪酶升高的CT胰腺炎)的连续CT胰腺容积数据。我们检查了类固醇对疼痛和疾病进程的影响。
    在AIPI(n=229)中,脂酶升高中位数是正常上限的4倍(范围:3-40倍).无症状的损伤多于疼痛(143/229(62%)vs86/229(38%),P<.000)。大多数(83/110(75%)的CT正常,通常在无痛与疼痛疾病中:51/57(90%)vs32/53(60%),P<.001)25%患有间质性胰腺炎。在连续胰腺容积测量中,在正常CT(中位数81.6vs61.3,P=.00)和CT组胰腺炎(91.8vs60.5,P=.00)中,脂肪酶升高前3个月出现明显的体积(cc)丢失,≥20%的体积损失发生在47%和73%,分别(P=.08)。类固醇,使用时不能减轻疼痛,生化复发,胰腺体积减少或1年糖尿病发病率(7.2%)。
    自身免疫性胰腺损伤(AIPI)的独特特征是无痛的脂肪酶升高,CT上胰腺正常,随访中胰腺体积迅速减少。类固醇似乎在管理中没有作用。
    UNASSIGNED: Immune checkpoint inhibitor therapy causes numerous immune-related adverse events, including autoimmune pancreatic injury (AIPI), which results in rapid organ atrophy. We profiled the clinico-radiological features, short-term natural history, and response to steroids of AIPI.
    UNASSIGNED: We retrospectively reviewed medical records of 229/11,165 (2.1%) adult patients with AIPI. One hundred and ten out of 229 (48%) had abdominal computerized tomography (CT) scan at lipase elevation; data of 110 without pancreatic metastases were analyzed. We analyzed serial CT-based pancreas volumetry data in 48 patients with AIPI (32 with normal CT and 16 with pancreatitis on CT at lipase elevation). We examined impact of steroids on pain and disease course.
    UNASSIGNED: In AIPI (n = 229), median lipase elevation was 4x upper limit of normal (range: 3-40x). The injury was more often asymptomatic than painful (143/229 (62%) vs 86/229 (38%), P < .000). Majority (83/110 (75%) had normal CT, often in painless vs painful disease: 51/57 (90%) vs 32/53 (60%), P < .001) 25% had interstitial pancreatitis. On serial pancreas volumetry, marked volume (cc) loss occurred 1 year after vs 3 months before lipase elevation in both normal CT (median 81.6 vs 61.3, P = .00) and pancreatitis on CT groups (91.8 vs 60.5, P = .00), ≥20% volume loss occurred in 47% vs 73%, respectively (P = .08). Steroids, when used did not mitigate pain, biochemical relapse, pancreas volume loss or 1-year diabetes incidence (7.2%).
    UNASSIGNED: Autoimmune pancreatic injury (AIPI) is uniquely characterized by painless lipase elevation, normal pancreas on CT and rapid pancreatic volume loss on follow-up. Steroids do not appear to have a role in management.
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  • 文章类型: Journal Article
    与免疫检查点抑制剂(ICI-AIN)相关的急性间质性肾炎(AIN)的病理生理学尚未完全了解。我们的目标是分析急性肾小管坏死(ATN)和AIN之间的区别可能的生物标志物,尤其是癌症患者,并研究免疫检查点途径在ICI-AIN中的参与。
    我们进行了一项观察性研究。我们招募了有ICI-AIN事件诊断的患者(n=19)。我们测量了可溶性PD-1(sPD-1),诊断时血清和尿液中的sPD-L1和sPD-L2,并与患有非ICI相关AIN(非ICI-AIN)(n=18)和ATN(n=21)的患者进行比较。这些发现在另一个机构的独立队列中得到了验证(n=30)。此外,我们对ICI-AIN患者的肾活检进行了PD-L1和PD-L2免疫染色,并与非ICI-AIN患者进行了比较.
    与ATN相比,AIN患者的尿sPD-1(usPD-1)更高(P=0.03)。AIN患者的血清sPD-1(ssPD-1)也高于ATN患者(P=.021)。在癌症患者中,usPD-1<129.3pg/ml对ATN和ICI-AIN的区分具有71.43%的敏感性和94.44%的特异性,似然比为12.86。在外部验证队列中,相同的截止值显示80%的灵敏度.在肾脏活检中,ICI-AIN患者的PD-L1阳性小管密度高于非ICI-AIN患者(P=.02).与非ICI-AIN相比,ICI-AIN患者中PD-L2阳性小管>2.64/mm2的患者比例更高(P=0.034)。usPD-1与PD-L1阳性小管数量呈正相关(P=.009,r=0.72)。
    UsPD-1和ssPD-1在AIN中高于ATN。此外,usPD-1和肾小管PD-L1表达之间有很强的相关性。我们的研究结果表明,usPD-1作为非侵入性生物标志物区分ICI-AIN和ATN的作用,尤其是癌症患者,这已在外部验证队列中得到证实。
    UNASSIGNED: Acute interstitial nephritis (AIN) related to immune checkpoint inhibitors (ICI-AIN) has a not completely understood pathophysiology. Our objectives were to analyze possible biomarkers for the differentiation between acute tubular necrosis (ATN) and AIN, especially in cancer patients, and to study the participation of the immune checkpoint pathway in ICI-AIN.
    UNASSIGNED: We performed an observational study. We recruited patients with incident diagnosis of ICI-AIN (n = 19). We measured soluble PD-1 (sPD-1), sPD-L1, and sPD-L2 in serum and urine at diagnosis and compared to it patients with non-ICI-related AIN (non-ICI-AIN) (n = 18) and ATN (n = 21). The findings were validated in an independent cohort from another institution (n = 30). Also, we performed PD-L1 and PD-L2 immunostaining of kidney biopsies from patients with ICI-AIN and compared to patients with non-ICI-AIN.
    UNASSIGNED: Urinary sPD-1 (usPD-1) was higher in patients with AIN compared to ATN (P = .03). Patients with AIN also showed higher serum sPD-1 (ssPD-1) than patients with ATN (P = .021). In cancer patients, usPD-1 <129.3 pg/ml had a 71.43% sensitivity and 94.44% specificity to differentiate ATN from ICI-AIN, with a likelihood ratio of 12.86. In the external validation cohort, the same cutoff showed a sensitivity of 80%. In kidney biopsies, patients with ICI-AIN showed higher density of PD-L1 positive tubules than patients with non-ICI-AIN (P = .02). The proportion of patients having >2.64/mm2 PD-L2 positive tubules was higher among patients with ICI-AIN compared to non-ICI-AIN (P = .034). There was a positive correlation (P = .009, r = 0.72) between usPD-1 and the number of PD-L1 positive tubules.
    UNASSIGNED: UsPD-1 and ssPD-1 are higher in AIN than ATN. Moreover, there was a strong correlation between usPD-1 and renal tubular PD-L1 expression. Our findings suggest a role of usPD-1 as non-invasive biomarker to differentiate ICI-AIN from ATN, especially in cancer patients, which has been confirmed in an external validation cohort.
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