CD4+T 细胞介导的免疫耐受对恶性胸腔积液发生发展影响的研究进展

[中图分类号] R734.3 [文献标志码] A

Research progress in effects of CD4+T cell-mediated immune tolerance on occurrence and development of malignant pleural effusion

A Geer，WANG Qin， JIAO Lijing， ZHOU Hailun，GAN Shanshan，HAN Yang，LIU Ruichao， GONG Yabin （First department of Oncology，Yueyang Hospital of Integrated Traditional Chinese and Western Medicine， ShanghaiUniversity of Traditional Chinese Medicine，Shanghai 2OO437，China）

ABSTRACTMalignant pleural effusion （MPE） is a common complication in patients with advancedmalignant tumors，which not only significantly reduces their quality of life but also shortens their survivalduration.Despite the widespread use of traditional treatment methods such as thoracentesis and pleurodesis，their efficacy is limited accompanied by high recurrence rates.Therefore，exploring novel therapeutic strategies becomes particularly urgent. In recent years，immunotherapy has atracted extensive attention for its potential in cancer treatment. This article systematically reviews the roles of CD4+T cell subsets， including regulatory T cels（Treg），T helper cell（Th）17，Th9，and Th22 cell，within the immunosuppressive microenvironment of MPE. These cell subsets are involved in the formation of the immunosuppressive state of MPE through various mechanisms and play key roles in the occurrence and development of the disease.In addition，the article discusses in detail the role of immune checkpoint molecules，such as programmed death protein 1（PD-1），PD-l ligand（PD-L1），and cytotoxic Tlymphocyte-associated protein 4（CTLA-4）， in the immune evasion of MPE. The abnormal expressions of these molecules provide opportunity for tumor cels to evade immune system surveillance.At the same time，this article also summarizes the application prospects of novel immunotherapy strategies，such as adoptive cell therapy（ACT）and chimeric antigen receptor T cell （CAR-T） therapy，in the treatment of MPE. These innovative therapies ofer possibilities for improving the prognosis of MPE patients through activating and enhancing the anti-tumor immune response.

KEYWORDsMalignant pleural effsion； Immune tolerance；Regulatory T cels；T helper 17 cels; Thelper 9 cells；Thelper 22 cells

恶性胸腔积液（malignantpleuraleffusion，MPE）是晚期恶性肿瘤患者常见的并发症，特别是在非小细胞肺癌（ 36% ）、乳腺癌（ 26% ）和淋巴瘤（ 13% ）患者中尤为多见[]。（剩余17414字）