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中国人民解放军总医院老年心血管病研究所
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
PD-1/PD-L1通路调控心肌炎发病的机制进展
Regulation on pathogenesis of myocarditis by PD-1/PD-L1 pathway
投稿时间:2019-05-05  修订日期:2019-05-29
DOI:
中文关键词:  心肌炎;免疫检查点;程序性死亡蛋白1;程序性死亡蛋白受体1
英文关键词:myocarditis; immune checkpoint; programmed cell death protein 1; programmed cell death-ligand 1
基金项目:
作者单位E-mail
胡舜英 解放军总医院第一医学中心 hsylily@163.com 
摘要点击次数: 45
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中文摘要:
      心肌炎是临床常见的心血管疾病,约50%的心肌炎患者面临不良预后,目前发病机制仍不明确。程序性死亡蛋白1(PD-1)是一类重要的免疫检查点,与其受体(PD-L1)结合后对机体免疫反应起负向调节作用,从而维持稳定的外周免疫耐受,在心肌炎的发生发展中起亦着重要的调控作用。研究显示PD-1/PD-L1通路通过调控活化T细胞、心肌自身抗体、抑制心肌炎症反应等机制抑制心肌炎的发生发展,其作用与机体的遗传易感性有关。以PD-1/ PD-L1抑制剂为代表的免疫检查点抑制剂在肿瘤治疗中应用日益广泛,其导致的心肌炎被认为是最威胁患者生命的毒副作用之一,可能与PD-1/ PD-L1抑制剂造成的外周免疫耐受崩溃等机制有关。明确PD-1/PD-L1通路调控心肌炎的发病机制将有助于为心肌炎寻求新的有效的诊治策略。
英文摘要:
      Myocarditis is a disease characterized by the presence of inflammatory infiltrates in the myocardium, which can lead to inflammatory dilated cardiomyopathy and ultimately to congestive heart failure. Programmed cell death protein 1 (PD-1) is one of immune checkpoints that negatively regulates immune responses by interacting with the specific programmed death-ligand 1 (PD-L1) and plays important roles in establishing peripheral tolerance to the heart. PD-1/PD-L1 pathway was reported to restrain myocarditis through regulating T cell activity, cardiac autoantibody and inhibiting inflammation, which is related to genetic susceptibility. Several blocking monoclonal antibodies targeting PD-1 and PD-L1 have been developed and have been shown effective to treat tumors. However, PD-1/PD-L1 inhibitors related myocarditis is life-threatening and brings out poor clinical outcome. Immune checkpoint inhibitors related myocarditis is probably due to breakdown of peripheral immune tolerance to the heart and leads to more poor prognosis than general myocarditis. We reviewed the researchs on regulation of PD-1/PD-L1 pathway on myocarditis , providing further understanding on the mechanism underlying myocarditis. PD-1/PD-L1 pathway could be a new target of therapeutic strategies for myocarditis.
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