{"id":33128,"date":"2018-11-29T00:05:28","date_gmt":"2018-11-28T16:05:28","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=33128"},"modified":"2018-11-26T16:59:29","modified_gmt":"2018-11-26T08:59:29","slug":"%e5%85%8d%e7%96%ab%e6%aa%a2%e6%9f%a5%e9%bb%9e%e6%8a%91%e5%88%b6%e5%8a%91%e7%9a%84%e6%ad%a1%e5%96%9c%e8%88%87%e6%82%b2%e5%82%b7%e4%b8%8b","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=33128","title":{"rendered":"\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u6b61\u559c\u8207\u60b2\u50b7(\u4e0b)"},"content":{"rendered":"<p><span style=\"color: #333399;\"><strong>\u25a0\u4eca\u5e74\u525b\u69ae\u7372\u8afe\u8c9d\u723e\u5f97\u4e3b\u7684 James Allison \u5728\u8a2a\u554f\u7684\u6642\u5019\u4e0d\u6b62\u4e00\u6b21\u63d0\u5230\u4ed6\u73fe\u5728\u6700\u95dc\u5fc3\u7684\u554f\u984c\uff0c\u5c31\u662f\u70ba\u4ec0\u9ebc\u53ea\u6709\u4e00\u90e8\u5206\u7684\u75c5\u4eba\u5c0d\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7642\u6cd5\u6709\u6548\u3002\u9019\u80cc\u5f8c\u7684\u6a5f\u8f49\u5230\u5e95\u662f\u4ec0\u9ebc\u5462\uff1f\u53c8\u6709\u6c92\u6709\u53ef\u80fd\uff0c\u80fd\u5920\u900f\u904e\u91ab\u5b78\u6aa2\u9a57\u7684\u65b9\u5f0f\uff0c\u5148\u77e5\u9053\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u5c0d\u54ea\u4e9b\u75c5\u4eba\u53ef\u80fd\u6703\u6700\u6709\u6548\uff0c\u5c0d\u54ea\u4e9b\u75c5\u4eba\u4f86\u8aaa\uff0c\u9019\u6cbb\u7642\u53c8\u53ea\u662f\u5f92\u52de\u7121\u529f\u7684\u778e\u5fd9\u4e00\u5834\u5462\uff1f<\/strong><\/span><\/p>\n<p><strong><img fetchpriority=\"high\" decoding=\"async\" class=\"alignleft wp-image-33133\" src=\"http:\/\/case.ntu.edu.tw\/blog\/wp-content\/uploads\/2018\/10\/fig-1.jpg\" alt=\"\" width=\"450\" height=\"312\" data-wp-pid=\"33133\">\u64b0\u6587\uff5c\u99f1\u5b9b\u7433<\/strong><\/p>\n<p>\u81ea 2011 \u8d77\uff0c\u5df2\u6709\u516d\u7a2e\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\uff0c\u901a\u904e\u7f8e\u570b\u98df\u54c1\u85e5\u7269\u7ba1\u7406\u5c40\u7684\u5be9\u6838\uff0c\u800c\u53ef\u7528\u65bc\u6cbb\u7642\u591a\u7a2e\u764c\u75c7\uff1b\u5305\u62ec\u4e86\u9ed1\u8272\u7d20\u7624\u76ae\u819a\u764c\u3001\u80ba\u764c\u7b49\u3002\u9019\u4e9b\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u4e0d\u8ad6\u662f\u7784\u6e96\u4e86 CTLA-4 \u9084\u662f PD-1 \u6216\u662f PD-L1\uff0c\u90fd\u610f\u5728\u963b\u65b7\u514d\u75ab\u6aa2\u67e5\u9ede\u7684\u6291\u5236\u6027\u8a0a\u606f\uff0c\u4f7f T \u7d30\u80de\u6d3b\u5316\u7684\u8a0a\u606f\u53ef\u4ee5\u66a2\u901a\u7121\u963b\u5730\u50b3\u5c0e\u4e0b\u53bb\u3002\u5957\u53e5\u8001\u6389\u7259\u7684\u6bd4\u55bb\uff1a\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u662f\u6545\u610f\u8b93 T \u7d30\u80de\u7684\u715e\u8eca\u5931\u9748\u3002\u65bc\u662f\uff0c\u60f3\u885d\u92d2\u9677\u9663\u6bba\u6575\u7684 T \u7d30\u80de\u4e00\u8def\u8173\u8e29\u6cb9\u9580\uff0c\u518d\u4e5f\u6c92\u6709\u6291\u5236\u6027\u50b3\u5c0e\u8a0a\u606f\u53ef\u4ee5\u628a T \u7d30\u80de\u62c9\u4f4f\u4e86\u3002<\/p>\n<p>\u8a31\u591a\u670d\u7528\u4e86\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u75c5\u4eba\u4e0d\u50c5\u85e5\u5230\u764c\u9664\uff0c\u800c\u4e14\uff0c\u4e0d\u5c11\u75c5\u4eba\u90fd\u6709\u6700\u5b8c\u7f8e\u7684\u7d50\u5c40\uff1a\u764c\u75c7\u4e0d\u518d\u5fa9\u767c\u3002\u4e5f\u56e0\u70ba\u6b64\uff0c\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u5c0d\u65bc\u6cbb\u7642\u764c\u75c7\u7684\u9b54\u529b\uff0c\u8b93\u4ee5\u6b64\u70ba\u5c0a\u7684\u6cbb\u7642\u65b9\u91dd\u5728\u9019\u5e7e\u5e74\u6210\u4e86\u91ab\u7642\u81e8\u5e8a\u4e0a\u7684\u91d1\u7ae5\u3001\u81e8\u5e8a\u8a66\u9a57\u4e0a\u7684\u7576\u7d05\u70b8\u5b50\u96de\u3002\u4f46\u4eba\u7121\u5341\u5168\uff0c\u85e5\u4e5f\u8c48\u80fd\u5341\u7f8e\uff1b\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u6709\u5f31\u9ede\u3001\u6709\u526f\u4f5c\u7528\uff0c\u4e5f\u6703\u529b\u6709\u672a\u902e\u3002<\/p>\n<p>\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u6700\u5927\u7684\u5f31\u9ede\uff0c\u5c31\u662f\u53ea\u5c0d\u90e8\u5206\u75c5\u4eba\u6709\u6548\u3002\u5982\u679c\u5c07\u6240\u6709\u53ef\u4ee5\u4f7f\u7528\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u764c\u75c7\u5168\u90e8\u6982\u62ec\u800c\u8ad6\uff0c\u76ee\u524d\u5927\u6982\u53ea\u6709\u4e94\u5206\u4e4b\u4e00\u7684\u75c5\u4eba\u5c0d\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u985e\u7684\u85e5\u7269\u6709\u53cd\u61c9\u3002\u4f46\u4e0d\u540c\u764c\u75c7\u4e4b\u9593\u7684\u5dee\u7570\u6027\u4e5f\u9817\u5927\uff0c\u50cf\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u5c0d\u65bc\u6cbb\u7642\u9ed1\u8272\u7d20\u7624\u5c31\u5f88\u6709\u6548\uff0c\u5c0d\u65bc\u6cbb\u7642\u8166\u764c\u5c31\u9084\u6709\u5f88\u5927\u3001\u5f88\u5927\u3001\u5f88\u5927\u7684\u9032\u6b65\u7a7a\u9593\u3002<\/p>\n<p>\u800c\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u6700\u5927\u7684\u526f\u4f5c\u7528\uff0c\u5c31\u662f\u5f15\u767c\u81ea\u9ad4\u514d\u75ab\u53cd\u61c9\u7684\u5371\u6a5f\u3002\u5c0d\u65bc\u514d\u75ab\u7d30\u80de T \u7d30\u80de\u4f86\u8aaa\uff0c\u6700\u81ea\u8c6a\u7684\u83ab\u904e\u65bc\u8fa8\u8b58\u6575\u6211\u7684\u80fd\u529b\u3002\u514d\u75ab\u7d30\u80de\u4e00\u76f4\u8d70\u5728\u4e00\u689d\u7d30\u5982\u9aee\u7d72\u7684\u754c\u7dda\u4e0a\uff1b\u65e2\u60f3\u8981\u9748\u654f\u5f97\u55c5\u51fa\u5916\u4f86\u5165\u4fb5\u8005\u75c5\u539f\u83cc\u7684\u8e64\u8de1\uff0c\u4ee5\u5343\u921e\u4e00\u523b\u7684\u9748\u6d3b\u8eab\u624b\u8d81\u65e9\u5c07\u4e4b\u7070\u98db\u7159\u6ec5\uff0c\u53c8\u5f97\u9867\u5168\u5927\u5c40\uff0c\u4e0d\u8b93\u81ea\u8eab\u7d30\u80de\u6158\u906d\u6c60\u9b5a\u4e4b\u6b83\u3002\u4f46\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u5229\u7528\u6297\u9ad4\u85e5\u7269\uff0c\u91cd\u65b0\u5e6b T \u7d30\u80de\u756b\u4e86\u4e00\u689d\u300c\u6575\u6211\u4e4b\u754c\u300d\u3002\u7576\u9019\u689d\u754c\u7dda\u7684\u6a19\u6e96\u964d\u4f4e\u7684\u6642\u5019\uff0cT \u7d30\u80de\u8b8a\u6210\u6297\u764c\u6230\u58eb\uff0c\u537b\u4e5f\u9023\u5e36\u5730\u8b93 T \u7d30\u80de\u6709\u53ef\u80fd\u8aa4\u64ca\u6b63\u5e38\u9ad4\u7d30\u80de\uff0c\u9020\u6210\u81ea\u9ad4\u514d\u75ab\u75be\u75c5\u3002<\/p>\n<p>\u6240\u8b02\u5371\u6a5f\u5c31\u662f\u8f49\u6a5f\uff0c\u7814\u7a76\u4eba\u54e1\u81ea\u7136\u500b\u500b\u78e8\u5200\u970d\u970d\u5730\u60f3\u8981\u89e3\u6c7a\u9019\u4e9b\u554f\u984c\u3002\u96d6\u7136\uff0c\u6211\u5011\u90fd\u6163\u7a31 CTLA-4 \u6297\u9ad4\u8ddf PD-1\u3001PD-L1 \u6297\u9ad4\u540c\u70ba\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u985e\u578b\u7684\u6297\u764c\u85e5\u7269\uff1b\u4e5f\u96d6\u7136\u5b83\u5011\u7684\u4f5c\u7528\u90fd\u662f\u963b\u65b7 T \u7d30\u80de\u6291\u5236\u578b\u8abf\u7bc0\u8a0a\u606f\uff0c\u4f46 CTLA-4 \u6297\u9ad4\u3001\u8ddf PD-1\uff0fPD-L1 \u6297\u9ad4\uff0c\u537b\u662f\u540c\u540d\u4e0d\u540c\u5fc3\uff0c\u85e5\u7269\u4f5c\u7528\u6a5f\u5236\u5dee\u7570\u5f88\u5927\u3002\u800c\u9019\uff0c\u4e5f\u76f4\u63a5\u5730\u5f71\u97ff\u5230\u4e86\u9019\u5169\u985e\u578b\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u6297\u764c\u6548\u679c\u3001\u526f\u4f5c\u7528\uff0c\u751a\u81f3\u662f\u672a\u4f86\u767c\u5c55\u6f5b\u529b\uff0c\u4ee5\u53ca\u63a5\u4e0b\u4f86\u7814\u7a76\u4eba\u54e1\u8a72\u5982\u4f55\u5c07\u5b83\u5011\u9032\u4e00\u90e8\u6539\u9020\u3002<\/p>\n<p>\u5148\u4f86\u8ac7\u8ac7\u514d\u75ab\u6aa2\u67e5\u6291\u5236\u5291\u88e1\u7684\u958b\u5c71\u7956\u5e2b\u723a CTLA-4 \u6297\u9ad4\u597d\u4e86\u3002\u5728 2000 \u5e74\u5de6\u53f3\u7684\u6642\u5019\uff0c\u6709\u5169\u96bb CTLA-4 \u6297\u9ad4\u9032\u5165\u81e8\u5e8a\u8a66\u9a57\uff0c\u5206\u5225\u662f ipilimumab \u548c tremelimumab\u3002CTLA-4 \u6297\u9ad4\u5c0d\u65bc\u62b5\u6297\u764c\u75c7\u7684\u4e0d\u51e1\u8868\u73fe\uff0c\u5f88\u5feb\u5730\u8b93\u5b83\u6210\u70ba\u773e\u6240\u77da\u76ee\u7684\u7126\u9ede\uff0c\u4f46\u96a8\u4e4b\u800c\u8d77\u7684\u526f\u4f5c\u7528\u537b\u4e5f\u50cf\u7aa9\u88e1\u53cd\u7684\u5167\u8cca\uff1aCTLA-4 \u6297\u9ad4\u7684\u6297\u764c\u7642\u6548\u6709\u591a\u8b93\u4eba\u9a5a\u5606\uff0c\u526f\u4f5c\u7528\u5c31\u6709\u591a\u8b93\u4eba\u982d\u75db\u3002\u6700\u5e38\u898b\u7684\u526f\u4f5c\u7528\u5305\u62ec\u8178\u708e\u3001\u76ae\u819a\u708e\u3001\u809d\u708e\u2014\u2014\u5c31\u50cf\u662f\u514d\u75ab\u7cfb\u7d71\u6bba\u764c\u7d30\u80de\u6bba\u7d05\u4e86\u773c\uff0c\u5728\u8eab\u9ad4\u5176\u4ed6\u5668\u5b98\u5230\u8655\u653e\u706b\u7684\u611f\u89ba\u3002<\/p>\n<p>CTLA-4 \u6297\u9ad4\u56e0\u6b64\u800c\u59d4\u5c48\u55ce\uff1f\u5176\u5be6\u4e5f\u4e0d\u3002\u5728 CTLA-4 \u57fa\u56e0\u5254\u9664\u8001\u9f20\u8eab\u4e0a\uff0c\u79d1\u5b78\u5bb6\u4e5f\u5c31\u89c0\u5bdf\u5230\u985e\u4f3c\u7684\u4e8b\u3002\u5929\u751f\u6c92\u6709 CTLA-4 \u57fa\u56e0\u7684\u8001\u9f20\uff0c\u5728\u51fa\u751f\u4e4b\u5f8c\u7684\u5e7e\u500b\u79ae\u62dc\u5167\uff0c\u514d\u75ab\u7d30\u80de\u5c31\u5230\u8655\u4fb5\u72af\u6b63\u5e38\u7d44\u7e54\uff0c\u9020\u6210\u5668\u5b98\u6b63\u5e38\u529f\u80fd\u53d7\u640d\u800c\u7d42\u4f7f\u5c0f\u9f20\u6b7b\u4ea1\u3002\u4ed4\u7d30\u7d30\u7a76\u8d77\u4f86\uff0cCTLA-4 \u7684\u300c\u715e\u8eca\u300d\u529f\u80fd\u662f\u5728 T \u7d30\u80de\u88ab\u6297\u539f\u5448\u73fe\u7d30\u80de\u6d3b\u5316\u968e\u6bb5\uff0c\u610f\u5728\u78ba\u4fdd T \u7d30\u80de\u4e0d\u6703\u5c0d\u81ea\u8eab\u7d30\u80de\u5167\u7684\u86cb\u767d\u8cea\u6240\u884d\u751f\u51fa\u4f86\u7684\u6297\u539f\u904e\u5ea6\u53cd\u61c9\u3002\u5c24\u5176\u5f8c\u4f86\u767c\u73fe\uff0c\u5728\u8abf\u7bc0\u6027 T \u7d30\u80de\u4e0a\uff08regulatory T cells\uff09\u66f4\u56e0\u70ba\u8868\u73fe\u4e86\u5927\u91cf\u7684 CTLA-4\uff0c\u800c\u610f\u5916\u6210\u70ba CTLA-4 \u6297\u9ad4\u7684\u6a19\u9776\u3002\u5e73\u5e38\uff0c\u8abf\u7bc0\u6027 T \u7d30\u80de\u8ca0\u8cac\u7dad\u6301\u5468\u908a\u5b89\u5be7\u3001\u9632\u7bc4\u514d\u75ab\u7cfb\u7d71\u904e\u5ea6\u53cd\u61c9\u800c\u653b\u64ca\u81ea\u8eab\u7d30\u80de\u8207\u7d44\u7e54\u5668\u5b98\u3002\u4f46\u662f\uff0c\u5728\u7d66\u85e5\u4e4b\u5f8c\uff0cCTLA-4 \u6297\u9ad4\u4e0d\u55ae\u55ae\u4f5c\u7528\u65bc\u80fd\u5920\u53bb\u6bba\u764c\u7d30\u80de\u7684 T \u7d30\u80de\u4e0a\uff0c\u66f4\u56e0\u70ba\u8abf\u7bc0\u6027 T \u7d30\u80de\u5927\u91cf\u8868\u73fe\u7684 CTLA-4\uff0c\u800c\u4e00\u8d77\u53d7\u5236\u65bc CTLA-4\u6297\u9ad4\u7684\u9023\u5750\u6cd5\uff0c\u9032\u800c\u5931\u53bb\u4e86\u8abf\u7bc0\u6027 T \u7d30\u80de\u7dad\u6301\u81ea\u8eab\u7d44\u7e54\u300c\u7121\u6230\u4e8b\u300d\u7684\u904b\u7c4c\u80fd\u529b\u3002\u800c\u9019\uff0c\u7121\u7591\u662f\u5c0d CTLA-4 \u6297\u9ad4\u7684\u6cbb\u7642\u526f\u4f5c\u7528\u706b\u4e0a\u6f86\u6cb9\u3002<\/p>\n<p>PD-1 \u6297\u9ad4\u6216\u662f PD-L1 \u6297\u9ad4\u7684\u4f5c\u7528\u6a5f\u5236\uff0c\u4e5f\u6b63\u56e0\u548c CTLA-4 \u53cd\u5176\u9053\u800c\u884c\uff0c\u958b\u51fa\u4e86\u5927\u597d\u524d\u666f\u3002PD-1 \u6297\u9ad4\u548c PD-L1 \u6297\u9ad4\u4f5c\u70ba\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u7d55\u5999\u8655\u5728\u54ea\u88e1\u5462\uff1f<\/p>\n<p>PD-1 \u548c CTLA-4 \u96d6\u7136\u90fd\u662f\u8868\u73fe\u65bc T \u7d30\u80de\u4e0a\u7684\u6291\u5236\u578b\u8a0a\u606f\u8abf\u7bc0\u6a1e\u7d10\uff0c\u4f46 PD-1 \u7684\u4e0d\u540c\u4e4b\u8655\u5728\u65bc\uff0cPD-1 \u7684\u9080\u8acb\u51fa\u5834\u8cbb\u9ad8\u4e00\u9ede\uff0c\u6bd4\u8f03\u96e3\u8acb\u5f97\u52d5\u3002\u5e73\u5e38\u6c92\u4e8b\u6642\uff0cPD-1 \u662f\u4e0d\u8868\u73fe\u7684\uff0c\u53ea\u6709\u5728\u6d3b\u5316\u7684 T \u7d30\u80de\uff08\u5c24\u5176\u662f\u9577\u671f\u767c\u708e\u74b0\u5883\u4e0b\uff09\u8eab\u4e0a\uff0c\u624d\u627e\u5f97\u5230 PD-1 \u7684\u8eab\u5f71\u3002\u800c\u4e14\uff0c\u5c31\u9023 PD-1 \u7684\u53d7\u9ad4\u4e4b\u4e00 PD-L1 \u4e5f\u662f\u5982\u6b64\u3002\u7576\u8eab\u9ad4\u5167\u6709\u767c\u708e\u53cd\u61c9\u3001T \u7d30\u80de\u88ab\u6d3b\u5316\u4e4b\u5f8c\uff0c\u6d3b\u5316\u7684 T \u7d30\u80de\u6703\u5206\u6ccc\u5e72\u64fe\u7d20 IFN\u0263\uff0c\u4f5c\u70ba T \u7d30\u80de\u4e3b\u5c0e\u7684\u514d\u75ab\u53cd\u61c9\u88e1\uff0c\u53cd\u64ca\u7684\u5c0d\u7b56\u4e4b\u4e00\u3002\u800c\u767c\u708e\u74b0\u5883\u88e1\u7684\u81ea\u8eab\u7d30\u80de\uff0c\u70ba\u4e86\u8981\u8b93 T \u7d30\u80de\u80fd\u5920\u77e5\u9053\u8ab0\u662f\u300c\u81ea\u5df1\u4eba\u300d\uff0c\u5c31\u6703\u555f\u52d5 PD-L1 \u7684\u8868\u9054\uff0c\u5c07 PD-L1 \u50cf\u81ea\u5bb6\u8ecd\u65d7\u4e00\u6a23\u9ad8\u9ad8\u7684\u639b\u5728\u7d30\u80de\u8868\u9762\u3002T \u7d30\u80de\u7d93\u7531 PD-1 \u63a5\u6536\u5230 PD-L1 \u7684\u8a0a\u606f\uff0c\u5c31\u4e0d\u6703\u70ba\u96e3\u81ea\u9ad4\u7d30\u80de\u3002<\/p>\n<p>\u4f46\uff0c\u764c\u75c7\u7d30\u80de\u7562\u7adf\u4e00\u525b\u958b\u59cb\u7684\u6642\u5019\uff0c\u4e5f\u662f\u300c\u81ea\u5df1\u4eba\u300d\u7d30\u80de\u3002\u9019\u5957\u300c\u8868\u9054 PD-L1\u300d\u7684\u5927\u9003\u96e3\u624b\u518a\uff0c\u4e0d\u4f46\u80cc\u5f97\u6efe\u74dc\u721b\u719f\uff0c\u751a\u81f3\u6709\u4e9b\u764c\u75c7\u7d30\u80de\u9084\u56e0\u6b64\u85c9\u7531\u57fa\u56e0\u7a81\u8b8a\uff0c\u4f86\u589e\u5f37 PD-L1 \u7684\u8868\u73fe\u91cf\uff0c\u5fb9\u5fb9\u5e95\u5e95\u62ab\u8457\u7f8a\u76ae\u3001\u5168\u5fc3\u505a\u72fc\u3002\u800c\u85c9\u8457\u5c0d\u75c5\u60a3\u6295\u85e5 PD-1 \u6297\u9ad4\u6216\u662f PD-L1 \u6297\u9ad4\uff0c\u5c31\u80fd\u6253\u4e82\u764c\u7d30\u80de\u81ea\u4ee5\u70ba\u7684\u9003\u96e3\u8a08\u756b\u3002<\/p>\n<p>\u96d6\u7136\uff0cPD-1 \u6297\u9ad4\u8207 PD-L1 \u6297\u9ad4\u4e5f\u9084\u662f\u96e3\u9003\u50b7\u6575\u4e03\u5206\u3001\u5fc5\u4e5f\u50b7\u5df1\u4e09\u5206\u7684\u5bbf\u547d\u3002\u4f46\u662f\uff0c\u5982\u679c\u4ed4\u7d30\u601d\u91cf PD-1 \u7684\u555f\u52d5\u6d41\u7a0b\uff0c\u4e0d\u96e3\u767c\u73fe PD-1 \u6b63\u56e0\u70ba\u5b83\u96e3\u8acb\u5f97\u52d5\uff0c\u800c\u8b93\u4ee5\u5b83\u70ba\u6a19\u9776\u85e5\u7269\u7684\u6cbb\u7642\u66f4\u6709\u524d\u77bb\u767c\u5c55\u6027\u3002<\/p>\n<p>\u8981\u8b93 PD-1 \u51fa\u5834\uff0c\u9996\u5148\uff0c\u8eab\u9ad4\u5167\u5df2\u7d93\u6709\u767c\u708e\u53cd\u61c9\u3002\u800c\u9019\u901a\u5e38\u4ee3\u8868 T \u7d30\u80de\u5df2\u7d93\u5075\u6e2c\u5230\u764c\u7d30\u80de\u6297\u539f\u7684\u8e64\u8de1\uff0c\u4e26\u4e14\u5faa\u7dda\u627e\u5230\u816b\u7624\u5927\u672c\u71df\u6240\u5728\u8655\u3002\u4f46\u662f\uff0c\u88ab\u6d3b\u5316\u7684 T \u7d30\u80de\u9ede\u8457\u5e72\u64fe\u7d20 IFN\u0263 \u7684\u70b8\u5f48\u60f3\u8981\u555f\u52d5\u514d\u75ab\u53cd\u61c9\uff0c\u537b\u53cd\u800c\u6253\u8349\u9a5a\u86c7\u7684\u8b93\u764c\u7d30\u80de\u5728 IFN\u0263 \u7684\u523a\u6fc0\u4e0b\uff0c\u8868\u73fe\u5927\u91cf\u7684 PD-L1 \u800c\u7159\u9727\u7030\u6f2b\uff0cT \u7d30\u80de\u4e5f\u56e0\u6b64\u4ec0\u9ebc\u9b3c\u764c\u7d30\u80de\u4e5f\u770b\u4e0d\u898b\u3002\u5728\u81e8\u5e8a\u4e0a\uff0c\u4e5f\u7684\u78ba\u5e38\u89c0\u5bdf\u5230\u816b\u7624\u7d44\u7e54\u88e1\u6709 T \u7d30\u80de\u7684\u5730\u65b9\uff0c\u5c31\u5e38\u5e38\u662f PD-L1 \u9ad8\u8868\u9054\u8655\u7684\u5730\u65b9\u3002<\/p>\n<p>\u6240\u4ee5\uff0cPD-1 \u6297\u9ad4\u6216\u662f PD-L1 \u6297\u9ad4\u5c31\u50cf\u662f\u8b93 T \u7d30\u80de\u5728\u90a3\u500b\u7159\u9727\u7030\u6f2b\u7684\u74b0\u5883\u88e1\uff0c\u9084\u662f\u53ef\u4ee5\u8996\u6575\u6e05\u695a\uff0c\u628a\u764c\u7d30\u80de\u4e00\u500b\u4e00\u500b\u7684\u6d88\u6ec5\u6389\u3002\u800c\u4e5f\u56e0\u70ba\u901a\u5e38\u6709\u767c\u708e\u53cd\u61c9\u8207 IFN\u0263 \u7684\u5730\u65b9\u624d\u6709 PD-L1\uff0c\u5c31\u7b97 T \u7d30\u80de\u7684\u300c\u6575\u6211\u6a19\u6e96\u300d\u88ab PD-1 \u6297\u9ad4\u6216\u662f PD-L1 \u6297\u9ad4\u6253\u4e82\uff0c\u76f8\u8f03\u65bcCTLA-4 \u6297\u9ad4\u7684\u5168\u9ad4\u5927\u8d66\u7b56\u7565\uff0cPD-1 \u6297\u9ad4\u8207 PD-L1 \u6297\u9ad4\u6240\u5f15\u8d77\u7684\u81ea\u9ad4\u514d\u75ab\u53cd\u61c9\u5371\u6a5f\u4e5f\u76f8\u8f03\u4e0b\uff0c\u8981\u4fb7\u9650\u8a31\u591a\u3002<\/p>\n<p>\u77ad\u89e3\u4e86\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u80cc\u5f8c\u6a5f\u5236\uff0c\u4e5f\u5c31\u4e0d\u96e3\u63a8\u6572\u51fa\u70ba\u4ec0\u9ebc\u53ea\u6709\u300c\u90e8\u5206\u300d\u75c5\u4eba\u9ad4\u5167\u7684 T \u7d30\u80de\uff0c\u5c0d\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u6709\u53cd\u61c9\u3002\u4ee5 PD-1 \u6297\u9ad4\u548c PD-L1 \u6297\u9ad4\u70ba\u4f8b\uff0c\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u85e5\u7269\u8981\u6709\u6548\uff0c\u5e7e\u500b\u95dc\u9375\u56e0\u7d20\u90fd\u5f97\u4e00\u61c9\u4ff1\u5168\u3001\u7f3a\u4e00\u4e0d\u53ef\u3002\u5176\u4e00\uff0c\u75c5\u4eba\u81ea\u8eab\u5167\u7684 T \u7d30\u80de\u5df2\u7d93\u555f\u52d5\u4e86\u6297\u764c\u6bba\u6575\u7684\u514d\u75ab\u53cd\u61c9\uff0c\u4f7f\u5f97\u764c\u7d30\u80de\u5468\u570d\u3001\u816b\u7624\u7d44\u7e54\u88e1\u5df2\u7d93\u6709\u805e\u98a8\u800c\u4f86\u7684 T \u7d30\u80de\u3002\u5176\u4e8c\uff0c\u764c\u7d30\u80de\u7684\u78ba\u662f\u9760\u8457\u5927\u91cf\u8868\u73fe PD-L1 \u4f86\u9003\u812b\u514d\u75ab\u53cd\u61c9\u7684\u8ffd\u6355\u3002<\/p>\n<p>\u4f46\uff0c\u4e0d\u662f\u6240\u6709\u7684\u764c\u75c7\u90fd\u80fd\u5982\u6b64\u8f15\u6613\u5730\u62c9\u97ff\u6d3b\u5316\u514d\u75ab\u53cd\u61c9\u7684\u8b66\u9234\u3002\u901a\u5e38\u7a81\u8b8a\u91cf\u9ad8\u7684\u764c\u75c7\uff08\u50cf\u662f\u9ed1\u8272\u7d20\u7624\uff09\uff0c\u5c31\u6bd4\u8f03\u5bb9\u6613\u56e0\u70ba\u6709\u5927\u91cf\u5f9e\u8b8a\u7570\u86cb\u767d\u884d\u751f\u51fa\u4f86\u7684\u764c\u7d30\u80de\u5c08\u5c6c\u6297\u539f\uff0c\u800c\u8b93 T \u7d30\u80de\u55c5\u51fa\u4e0d\u5c0d\u52c1\u7684\u7aef\u502a\u3002\u7a81\u8b8a\u91cf\u5c0f\u7684\u764c\u75c7\uff0c\u76f8\u5c0d\u800c\u8a00\u5c31\u4e0d\u662f\u9019\u9ebc\u5bb9\u6613\u80fd\u5920\u6d3b\u5316\u514d\u75ab\u53cd\u61c9\u3002\u5c31\u7b97\u540c\u6a23\u7684\u764c\u75c7\uff0c\u75c5\u4eba\u81ea\u8eab\u514d\u75ab\u7cfb\u7d71\u7684\u5dee\u7570\u6027\u4e5f\u8b93\u9019\u7b2c\u4e00\u500b\u5fc5\u8981\u56e0\u5b50\u7684\u5b58\u5728\uff0c\u5145\u6eff\u4e86\u8b8a\u6578\u3002\u518d\u8005\uff0c\u764c\u7d30\u80de\u8a6d\u8a08\u591a\u7aef\uff0c\u5927\u91cf\u8868\u73fe PD-L1 \u7d55\u975e\u50c5\u6b64\u552f\u4e00\u4e00\u500b\u764c\u7d30\u80de\u80fd\u60f3\u5230\u7684\u9003\u812b\u7b56\u7565\u3002\u56e0\u6b64\uff0c\u5982\u679c\u80fd\u5920\u5148\u85c9\u7531\u67d0\u4e9b\u6aa2\u67e5\uff0c\u4f86\u9810\u6e2c\u75c5\u4eba\u7684\u75c5\u60c5\u6703\u4e0d\u6703\u56e0\u70ba\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u800c\u597d\u8f49\uff0c\u518d\u4f86\u6c7a\u5b9a\u6cbb\u7642\u7b56\u7565\uff0c\u6216\u8a31\u5c31\u80fd\u5920\u63d0\u5347\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7684\u6297\u764c\u6210\u529f\u7387\u4e86\u5462\u3002\u800c\u9019\uff0c\u4e5f\u662f\u5404\u500b\u7814\u7a76\u4eba\u54e1\u60f3\u8981\u52aa\u529b\u7684\u65b9\u5411\uff01<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n<ol>\n<li>Ribas A, Wolchok JD. Cancer immunotherapy using checkpoint blockade. Science. 2018 Mar 23;359(6382):1350-1355. doi: 10.1126\/science.aar4060. Epub 2018 Mar 22.<\/li>\n<li>Sanmamed MF, Chen L. A Paradigm Shift in Cancer Immunotherapy: From Enhancement to Normalization. Cell. 2018 Oct 4;175(2):313-326. doi: 10.1016\/j.cell.2018.09.035. Review. PMID: 30290139<\/li>\n<li>Kim TK, Herbst RS, Chen L. Defining and Understanding Adaptive Resistance in Cancer Immunotherapy. Trends Immunol. 2018 Aug;39(8):624-631. doi: 10.1016\/j.it.2018.05.001. Epub 2018 May 22. Review.<\/li>\n<li>Zou W, Wolchok JD, Chen L. PD-L1 (B7-H1) and PD-1 pathway blockade for cancer therapy: Mechanisms, response biomarkers, and combinations. Sci Transl Med. 2016 Mar 2;8(328):328rv4. doi: 10.1126\/scitranslmed.aad7118. Review. PMID: 26936508<\/li>\n<li>Chen L, Han X. Anti-PD-1\/PD-L1 therapy of human cancer: past, present, and future. J Clin Invest. 2015 Sep;125(9):3384-91. doi: 10.1172\/JCI80011. Epub 2015 Sep 1. Review. PMID: 26325035<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><strong>--<\/strong><br \/>\n<strong>\u4f5c\u8005\uff1a\u99f1\u5b9b\u7433\u3000\u7f8e\u570b\u8056\u8def\u6613\u83ef\u76db\u9813\u5927\u5b78\uff08Washington University in St. Louis\uff09\u514d\u75ab\u5b78\u535a\u58eb\uff0c\u5f9e\u4e8bT\u7d30\u80de\u767c\u80b2\u8207\u6d3b\u5316\u76f8\u95dc\u7684\u8a0a\u606f\u50b3\u5c0e\u7814\u7a76\u3002<\/strong><\/p>\n<p><a href=\"https:\/\/line.me\/R\/ti\/p\/%40fcx6182w\" target=\"_blank\" rel=\"noopener noreferrer\"><img decoding=\"async\" class=\"alignnone\" src=\"https:\/\/scdn.line-apps.com\/n\/line_add_friends\/btn\/zh-Hant.png\" alt=\"\u52a0\u5165\u597d\u53cb\" width=\"212\" height=\"36\" border=\"0\"><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u25a0\u4eca\u5e74\u525b\u69ae\u7372\u8afe\u8c9d\u723e\u5f97\u4e3b\u7684 James Allison \u5728\u8a2a\u554f\u7684\u6642\u5019\u4e0d\u6b62\u4e00\u6b21\u63d0\u5230\u4ed6\u73fe\u5728\u6700\u95dc\u5fc3\u7684\u554f\u984c\uff0c\u5c31\u662f\u70ba\u4ec0\u9ebc\u53ea\u6709\u4e00\u90e8\u5206\u7684\u75c5\u4eba\u5c0d\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u7642\u6cd5\u6709\u6548\u3002\u9019\u80cc\u5f8c\u7684\u6a5f\u8f49\u5230\u5e95\u662f\u4ec0\u9ebc\u5462\uff1f\u53c8\u6709\u6c92\u6709\u53ef\u80fd\uff0c\u80fd\u5920\u900f\u904e\u91ab\u5b78\u6aa2\u9a57\u7684\u65b9\u5f0f\uff0c\u5148\u77e5\u9053\u514d\u75ab\u6aa2\u67e5\u9ede\u6291\u5236\u5291\u5c0d\u54ea\u4e9b\u75c5\u4eba\u53ef\u80fd\u6703\u6700\u6709\u6548\uff0c\u5c0d\u54ea\u4e9b\u75c5\u4eba\u4f86\u8aaa\uff0c\u9019\u6cbb\u7642\u53c8\u53ea\u662f\u5f92\u52de\u7121\u529f\u7684\u778e\u5fd9\u4e00\u5834\u5462\uff1f<\/p>\n","protected":false},"author":20,"featured_media":33133,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3293,1025],"tags":[4065,4013,938,702,378,1454],"aioseo_notices":[],"jetpack_featured_media_url":"https:\/\/case.ntu.edu.tw\/blog\/wp-content\/uploads\/2018\/10\/fig-1.jpg","_links":{"self":[{"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/posts\/33128"}],"collection":[{"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=33128"}],"version-history":[{"count":2,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/posts\/33128\/revisions"}],"predecessor-version":[{"id":33147,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/posts\/33128\/revisions\/33147"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=\/wp\/v2\/media\/33133"}],"wp:attachment":[{"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=33128"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=33128"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/case.ntu.edu.tw\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=33128"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}