免疫系统在脑转移中的作用。

Current neurobiology Pub Date : 2019-07-01
Adam T Leibold, Gina N Monaco, Mahua Dey
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引用次数: 0

摘要

转移性脑肿瘤是成人中最常见的脑肿瘤。随着大多数常见癌症类型的全身治疗取得了许多成功的进展,脑转移在癌症患者的整体预后中变得越来越重要。外周肿瘤脑转移是原发肿瘤、免疫系统和中枢神经微环境复杂相互作用的结果。脑转移瘤一旦形成,就会隐藏在血脑屏障后面,无法进行化疗,而化疗本来可以成功地靶向全身性癌症。免疫检查点抑制剂被批准用于几种常见的癌症,如晚期黑色素瘤和肺癌,这为进一步了解肿瘤扩散到大脑的免疫抑制机制以及大脑环境和肿瘤微环境之间的相互作用带来了机会和义务。在这篇综述文章中,我们定义了免疫系统在脑转移发展中的核心作用。我们对文献进行了全面的回顾,概述了肿瘤使用免疫抑制的分子机制,以及免疫系统如何与中枢神经系统相互作用以促进脑转移。我们特别讨论了优先转移到大脑的癌症的肿瘤类型特异性转移机制以及有效调节免疫反应的治疗方法,如免疫检查点抑制剂和疫苗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The role of the immune system in brain metastasis.

The role of the immune system in brain metastasis.

The role of the immune system in brain metastasis.

The role of the immune system in brain metastasis.

Metastatic brain tumors are the most common brain tumors in adults. With numerous successful advancements in systemic treatment of most common cancer types, brain metastasis is becoming increasingly important in the overall prognosis of cancer patients. Brain metastasis of peripheral tumor is the result of complex interplay of primary tumor, immune system and central nervous system microenvironment. Once formed, brain metastases hide behind the blood brain barrier and become inaccessible to chemotherapies that are otherwise successful in targeting systemic cancer. The approval of immune checkpoint inhibitors for several common cancers such as advanced melanoma and lung cancers brings with it the opportunity and obligation to further understand the mechanisms of immunosuppression by tumors that spread to the brain as well as the interaction between the brain environment and tumor microenvironment. In this review paper we define the central role of the immune system in the development of brain metastases. We performed a comprehensive review of the literature to outline the molecular mechanisms of immunosuppression used by tumors and how the immune system interacts with the central nervous system to facilitate brain metastasis. In particular we discuss the tumor-type-specific mechanisms of metastasis of cancers that preferentially metastasize to the brain as well as the therapies that effectively modulate the immune response, such as immune checkpoint inhibitors and vaccines.

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