免疫療法の失敗に関する新データががん患者に希望を(New data sheds light on immunotherapy failure – bringing hope to patients with cancer)

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2025-09-17 バーミンガム大学

バーミンガム大学の研究チームらは、がん免疫療法が効かない患者がいる原因として、血中を漂うタンパク質「sClever-1」が免疫応答を抑制していることを突き止めた。sClever-1は通常免疫細胞に発現する受容体型タンパク質Clever-1の分泌型で、血液中を循環して活性化されたT細胞に結合し、その働きを抑えてしまう。これが腫瘍に対する免疫の攻撃を弱め、免疫チェックポイント阻害薬などの治療が効果を示さない原因となっている。研究では、sClever-1の血中濃度が高い患者ほど免疫療法への抵抗性を示す傾向があり、将来的にバイオマーカーとして予測指標にもなり得るとされた。また、sClever-1の分泌を抑える抗体「bexmarilimab」の作用により、この抑制効果を解除し、T細胞を再活性化できる可能性も示された。これにより、これまで反応が得られなかった患者にも免疫療法を効かせる治療戦略の道が開かれる。

<関連情報>

分泌されたClever-1はT細胞応答を調節し、癌免疫療法の有効性に影響を与える Secreted Clever-1 modulates T cell responses and impacts cancer immunotherapy efficacy

Stuart Prince, Miro Viitala, Riikka Sjöroos, Ábris Á. Bendes,, Jenna H. Rannikko, Daniel A. Patten, Ilaria di Benedetto, Rita Turpin, Arno Ylitalo, Laura Tyni, Carlos R. Figueiredo, Pia Boström, Ilkka Koskivuo, Tiina A. Salminen, Shishir Shetty, Maija Hollmén
Theranostics  Published: 2025-6-23
DOI:10.7150/thno.110544

Abstract

免疫療法の失敗に関する新データががん患者に希望を(New data sheds light on immunotherapy failure – bringing hope to patients with cancer)

Rationale: Clever-1 is a multifunctional scavenger receptor that promotes immunosuppressive activity in macrophages, contributing to tumor immune evasion. Its high expression correlates with resistance to immune checkpoint inhibitors, and co-targeting Clever-1 with anti-PD-1 enhances therapeutic efficacy in refractory tumor models. The humanized anti-Clever-1 IgG4 antibody, bexmarilimab, is under clinical investigation for treating solid tumors (NCT03733990) and hematological malignancies (NCT05428969).

Methods: To assess the impact of Clever-1 in cancer, we analyzed plasma samples from breast cancer patients (n=139) and bexmarilimab-treated clinical trial participants (n=193) using TRFIA-based ELISA to quantify secreted Clever-1 (sClever-1). A recombinant sClever-1 protein was produced and characterized biophysically. Functional assays, including flow cytometry, Western blotting, T cell activation, and Jurkat reporter systems, were used to assess interactions with T cells. Mechanistic studies involved extracellular vesicle isolation, pulldown assays, and mass spectrometry. Inhibitor studies and patient-derived tumor explants were used to evaluate the immunomodulatory impact of sClever-1 and its effect on anti-PD-1 responses.

Results: sClever-1 was significantly enriched in the plasma of cancer patients and reduced following bexmarilimab treatment. Its release was induced by IFNγ/LPS via serine protease-dependent cleavage. The recombinant sClever-1 bound selectively to activated T cells via mannose-6-phosphate-mediated interaction with IGF2R, impairing TCR signaling and Th1 expansion. sClever-1 was also associated with macrophage-derived extracellular vesicles and contributed to T cell tolerance and reduced anti-PD-1 efficacy. In tumor explants, sClever-1 bound to activated CD4+ and CD8+ T cells and increased TGFβ secretion.

Conclusions: These findings identify sClever-1 as a previously unrecognized, immunosuppressive mediator in cancer that operates independently of cellular Clever-1 expression. sClever-1 may serve as both a therapeutic target and biomarker to guide immunotherapy strategies.

医療・健康
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