IDO1介导的子宫内膜癌免疫逃逸机制及相关临床进展

IDO1-mediated immune escape mechanisms in endometrial cancer and related clinical progress

  • 摘要: 子宫内膜癌是女性生殖系统常见恶性肿瘤之一,其发病率呈逐年上升趋势。早期子宫内膜癌患者预后良好,但晚期及复发性子宫内膜癌患者预后极差。近年来,免疫检查点抑制剂在肿瘤治疗中取得重大进展,也是晚期及复发性子宫内膜癌患者重要治疗手段,但仍有部分患者在免疫治疗中出现疾病进展,肿瘤免疫逃逸机制仍需进一步研究。吲哚胺2,3-双加氧酶1(indoleamine 2,3-dioxyfenase-1,IDO1)催化色氨酸主要代谢通路的首个限速步骤,可催化色氨酸代谢生成犬尿氨酸, IDO1过度表达造成肿瘤微环境中色氨酸的耗竭及犬尿氨酸代谢产物的过度生成,从而在癌症免疫逃逸中发挥关键作用。本文对IDO1通路在子宫内膜癌中激活免疫逃逸的机制及以IDO1通路为靶点的子宫内膜癌免疫治疗研究进展进行综述。

     

    Abstract: Endometrial cancer (EC) is a common malignant tumor within the female reproductive system, and its incidence is increasing. The prognosis for patients with early EC is good, but the prognosis for patients with advanced and recurrent EC is extremely poor. In recent years, immune checkpoint inhibitors have shown significant promise in tumor therapy, including therapy for patients with advanced and recurrent EC. Some of these patients experience disease progression during immunotherapy, and the mechanism of tumor immune escape is not thoroughly understood. Indoleamine 2, 3-dioxyfenase-1 (IDO1) catalyzes the conversion of tryptophan to kynurenine, which is the first and rate-limiting step in the major pathway of tryptophan catabolism. IDO1 overexpression in a tumor microenvironment results in tryptophan depletion and kynurenine metabolites overproduction, facilitating cancer immune escape. We review the primary mechanisms by which the IDO1 pathway facilitates immune escape in EC, and describe research progress into EC therapy targeting the IDO1 pathway.

     

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