Fas配体(凋亡诱导分子)成为1型糖尿病潜在的非传统免疫治疗靶点
发布时间:2012-10-08 15:26:40浏览次数:3259次来源:吉林大学白求恩第二医院 摘自:Front Immunol. 2012;3:196. Epub 2012 Jul 12.
1型糖尿病的发展由胰岛中的自身反应性T细胞攻击、破坏产生胰岛素的胰岛β细胞启动,迫使患者采取每日多次胰岛素注射。然而,胰岛素治疗并不能治愈糖尿病,而且糖尿病患者通常会发生严重的长期微血管和心血管并发症。因此,应大力致力于开发安全的不损伤宿主防御功能并能保护β细胞的免疫疗法,使血糖的控制优于外源胰岛素疗法。选择性削弱或耐受自身免疫性致糖尿病T细胞,同时保留维持免疫系统活性所必需的保护性T细胞的工程疗法,已经被证实具有挑战性。相反,近期的研究都集中在调整和重建免疫系统而不是应用抗CD3抗体和抗CD20抗体分别清除T细胞和B细胞。到目前为止,Ⅲ期临床试验已经显示出这些方法是有希望的,但功效不强。所以,确认新的不符合免疫细胞活化经典属性的生物学靶点是必要的。在这项前瞻性研究中,我们提供的临床前期证据表明,在不导致免疫抑制的情况下,以FAS配体(FasL)作为靶点,或许可提供唯一的机会来预防或治疗T1D和其他器官特异性自身免疫性疾病。与传统的T和B淋巴细胞活化(例如CD3和CD20)参与的靶点不同,FasL是细胞凋亡诱导表面分子,通过与Fas(又称为CD95 Apo-1)触发细胞凋亡。因此,以FasL作为靶点预计不会出现免疫抑制,其正是传统治疗中的致命弱点。我们假设FasL靶向治疗会带来现有的免疫调节方法不能提供的独有的收益。近期的体内试验数据证实,封闭FasL的抗体可特异并显著地阻止T1D的发展。明确Fas介导的凋亡是介导了近期被发现与T1D患者β细胞杀伤有关的致糖尿病性的CD8细胞的细胞毒性,还是参与了杀伤负责保护胰岛免受自身反应性T细胞损伤的调节细胞,将变得异常有趣。本项研究的目的和预期就是,通过这种前景,激起可以阐述Fas途径在调节自身免疫性糖尿病和其他器官特异性自身免疫性疾病中的作用的探索。
The potential of Fas ligand (apoptosis-inducing molecule) as an unconventional therapeutic target in type 1 diabetes.
The development of type 1 diabetes (T1D) is driven by autoreactive T cells that attack and destroy the insulin-producing β-cells in pancreatic islets, forcing patients to take multiple daily insulin injections. Insulin therapy, however, is not a cure and diabetic patients often develop serious long-term microvascular and cardiovascular complications. Therefore, intensive efforts are being directed toward developing safe immunotherapy for the disease that does not impair host defense and preserves
β-cells, leading to better glycemic control than exogenous insulin therapy. Engineering therapies that differentially cripple or tolerate autoreactive diabetogenic T cells while sparing protective T cells necessary for maintaining a competent immune system has proven challenging. Instead, recent efforts have focused on modulating or resetting the immune system through global but transient deletion of T cells or B cells using anti-CD3 or anti-CD20 mAb, respectively. However, phase III clinical trials have shown promising but modest efficacy so far with these approaches. Therefore, there is a need to identify novel biological targets that do not fit the classic properties of being involved in adaptive immune cell activation. In this prospective, we provide preclinical evidence that targeting Fas ligand (FasL) may provide a unique opportunity to prevent or cure T1D and perhaps other organ-specific autoimmune diseases without causing immune suppression. Unlike conventional targets that are involved in T and B lymphocyte activation (such as CD3 and CD20, respectively), FasL is an apoptosis-inducing surface molecule that triggers cell death by binding to Fas (also known asCD95 Apo-1). Therefore, targeting FasL is not expected to cause immune suppression, the Achilles Heel of conventional approaches. We will discuss the hypothesis that targeting FasL has unique benefits that are not offered by current immunomodulatory approaches.
链接: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395106/?tool=pubmed