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The role of circulating cell-free DNA as an inflammatory mediator after stroke. 卒中后循环无细胞DNA作为炎症介质的作用。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00993-5
Stefan Roth, Saskia R Wernsdorf, Arthur Liesz

Stroke is the second leading cause of death worldwide and a leading cause of disability. Clinical and experimental studies highlighted the complex role of the immune system in the pathophysiology of stroke. Ischemic brain injury leads to the release of cell-free DNA, a damage-associated molecular pattern, which binds to pattern recognition receptors on immune cells such as toll-like receptors and cytosolic inflammasome sensors. The downstream signaling cascade then induces a rapid inflammatory response. In this review, we are highlighting the characteristics of cell-free DNA and how these can affect a local as well as a systemic response after stroke. For this purpose, we screened literature on clinical studies investigating cell-free DNA concentration and properties after brain ischemia. We report the current understanding for mechanisms of DNA uptake and sensing in the context of post-stroke inflammation. Moreover, we compare possible treatment options targeting cell-free DNA, DNA-sensing pathways, and the downstream mediators. Finally, we describe clinical implications of this inflammatory pathway for stroke patients, open questions, and potential future research directions.

中风是全世界第二大死亡原因,也是导致残疾的主要原因。临床和实验研究强调了免疫系统在中风病理生理中的复杂作用。缺血性脑损伤导致无细胞DNA的释放,这是一种与损伤相关的分子模式,它与免疫细胞上的模式识别受体结合,如toll样受体和细胞质炎性小体传感器。随后,下游的信号级联诱导了快速的炎症反应。在这篇综述中,我们强调了无细胞DNA的特征以及这些特征如何影响中风后的局部和全身反应。为此,我们筛选了有关脑缺血后游离DNA浓度和特性的临床研究文献。我们报告了目前对脑卒中后炎症背景下DNA摄取和感知机制的理解。此外,我们比较了针对无细胞DNA、DNA传感途径和下游介质的可能治疗方案。最后,我们描述了这种炎症途径对中风患者的临床意义,开放性问题和潜在的未来研究方向。
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引用次数: 1
Immune compartments at the brain's borders in health and neurovascular diseases. 健康和神经血管疾病中大脑边界的免疫区。
IF 7.9 2区 医学 Q1 IMMUNOLOGY Pub Date : 2023-05-01 Epub Date: 2023-05-03 DOI: 10.1007/s00281-023-00992-6
Jennifer E Goertz, Lidia Garcia-Bonilla, Costantino Iadecola, Josef Anrather

Recent evidence implicates cranial border immune compartments in the meninges, choroid plexus, circumventricular organs, and skull bone marrow in several neuroinflammatory and neoplastic diseases. Their pathogenic importance has also been described for cardiovascular diseases such as hypertension and stroke. In this review, we will examine the cellular composition of these cranial border immune niches, the potential pathways through which they might interact, and the evidence linking them to cardiovascular disease.

最近的证据表明,脑膜、脉络丛、脑周器官和颅骨骨髓中的颅缘免疫区与多种神经炎症和肿瘤性疾病有关。它们在高血压和中风等心血管疾病中的重要致病作用也已得到描述。在这篇综述中,我们将研究这些颅缘免疫龛的细胞组成、它们可能相互作用的潜在途径以及它们与心血管疾病相关的证据。
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引用次数: 0
Role of glia and extracellular matrix in controlling neuroplasticity in the central nervous system. 神经胶质和细胞外基质在中枢神经系统神经可塑性调控中的作用。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00989-1
Egor Dzyubenko, Dirk M Hermann

Neuronal plasticity is critical for the maintenance and modulation of brain activity. Emerging evidence indicates that glial cells actively shape neuroplasticity, allowing for highly flexible regulation of synaptic transmission, neuronal excitability, and network synchronization. Astrocytes regulate synaptogenesis, stabilize synaptic connectivity, and preserve the balance between excitation and inhibition in neuronal networks. Microglia, the brain-resident immune cells, continuously monitor and sculpt synapses, allowing for the remodeling of brain circuits. Glia-mediated neuroplasticity is driven by neuronal activity, controlled by a plethora of feedback signaling mechanisms and crucially involves extracellular matrix remodeling in the central nervous system. This review summarizes the key findings considering neurotransmission regulation and metabolic support by astrocyte-neuronal networks, and synaptic remodeling mediated by microglia. Novel data indicate that astrocytes and microglia are pivotal for controlling brain function, indicating the necessity to rethink neurocentric neuroplasticity views.

神经元的可塑性是维持和调节大脑活动的关键。新出现的证据表明,神经胶质细胞积极塑造神经可塑性,允许突触传递,神经元兴奋性和网络同步的高度灵活的调节。星形胶质细胞调节突触发生,稳定突触连通性,保持神经元网络兴奋和抑制之间的平衡。小胶质细胞,驻留在大脑中的免疫细胞,持续监测和塑造突触,允许重塑大脑回路。胶质细胞介导的神经可塑性由神经元活动驱动,由大量反馈信号机制控制,关键涉及中枢神经系统的细胞外基质重塑。本文综述了星形胶质细胞-神经元网络对神经传递的调节和代谢支持,以及小胶质细胞介导的突触重塑等方面的主要研究成果。新的数据表明星形胶质细胞和小胶质细胞在控制脑功能方面起着关键作用,这表明有必要重新思考神经中心神经可塑性的观点。
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引用次数: 6
Systemic innate myeloid responses to acute ischaemic and haemorrhagic stroke. 急性缺血性和出血性中风的系统性先天性骨髓反应。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 Epub Date: 2022-11-08 DOI: 10.1007/s00281-022-00968-y
Ruth Stephens, John R Grainger, Craig J Smith, Stuart M Allan

Acute ischaemic and haemorrhagic stroke account for significant disability and morbidity burdens worldwide. The myeloid arm of the peripheral innate immune system is critical in the immunological response to acute ischaemic and haemorrhagic stroke. Neutrophils, monocytes, and dendritic cells (DC) contribute to the evolution of pathogenic local and systemic inflammation, whilst maintaining a critical role in ongoing immunity protecting against secondary infections. This review aims to summarise the key alterations to myeloid immunity in acute ischaemic stroke, intracerebral haemorrhage (ICH), and subarachnoid haemorrhage (SAH). By integrating clinical and preclinical research, we discover how myeloid immunity is affected across multiple organ systems including the brain, blood, bone marrow, spleen, and lung, and evaluate how these perturbations associate with real-world outcomes including infection. These findings are placed in the context of the rapidly developing field of human immunology, which offers a wealth of opportunity for further research.

急性缺血性和出血性中风在全世界造成了巨大的残疾和发病负担。外周先天免疫系统的骨髓臂在急性缺血性和出血性中风的免疫反应中至关重要。中性粒细胞、单核细胞和树突状细胞(DC)有助于致病性局部和全身炎症的进化,同时在持续免疫中保持关键作用,防止继发感染。这篇综述旨在总结急性缺血性中风、脑出血(ICH)和蛛网膜下腔出血(SAH)中骨髓免疫的关键变化。通过整合临床和临床前研究,我们发现了骨髓免疫如何在包括大脑、血液、骨髓、脾脏和肺部在内的多个器官系统中受到影响,并评估了这些干扰如何与包括感染在内的现实世界结果相关联。这些发现是在人类免疫学领域快速发展的背景下得出的,这为进一步研究提供了丰富的机会。
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引用次数: 2
The role of the ATP-adenosine axis in ischemic stroke. atp -腺苷轴在缺血性卒中中的作用。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00987-3
Ines Sophie Schädlich, Riekje Winzer, Joschi Stabernack, Eva Tolosa, Tim Magnus, Björn Rissiek

In ischemic stroke, the primary neuronal injury caused by the disruption of energy supply is further exacerbated by secondary sterile inflammation. The inflammatory cascade is largely initiated by the purine adenosine triphosphate (ATP) which is extensively released to the interstitial space during brain ischemia and functions as an extracellular danger signaling molecule. By engaging P2 receptors, extracellular ATP activates microglia leading to cytokine and chemokine production and subsequent immune cell recruitment from the periphery which further amplifies post-stroke inflammation. The ectonucleotidases CD39 and CD73 shape and balance the inflammatory environment by stepwise degrading extracellular ATP to adenosine which itself has neuroprotective and anti-inflammatory signaling properties. The neuroprotective effects of adenosine are mainly mediated through A1 receptors and inhibition of glutamatergic excitotoxicity, while the anti-inflammatory capacities of adenosine have been primarily attributed to A2A receptor activation on infiltrating immune cells in the subacute phase after stroke. In this review, we summarize the current state of knowledge on the ATP-adenosine axis in ischemic stroke, discuss contradictory results, and point out potential pitfalls towards translating therapeutic approaches from rodent stroke models to human patients.

在缺血性卒中中,能量供应中断引起的原发性神经元损伤会因继发性无菌炎症而进一步加剧。炎症级联反应主要由嘌呤三磷酸腺苷(ATP)引发,ATP在脑缺血时广泛释放到脑间质,是一种细胞外危险信号分子。通过参与P2受体,细胞外ATP激活小胶质细胞,导致细胞因子和趋化因子的产生,随后从外周募集免疫细胞,进一步放大脑卒中后炎症。外核苷酶CD39和CD73通过逐步将细胞外ATP降解为腺苷来形成和平衡炎症环境,腺苷本身具有神经保护和抗炎信号特性。腺苷的神经保护作用主要通过A1受体和抑制谷氨酸能兴奋性毒性介导,而腺苷的抗炎能力主要归因于A2A受体在脑卒中亚急性期对浸润性免疫细胞的激活。在这篇综述中,我们总结了缺血性卒中中atp -腺苷轴的知识现状,讨论了相互矛盾的结果,并指出了将啮齿动物卒中模型的治疗方法转化为人类患者的潜在缺陷。
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引用次数: 5
The immunopathology of B lymphocytes during stroke-induced injury and repair. 脑卒中损伤及修复过程中B淋巴细胞的免疫病理。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-022-00971-3
Mary K Malone, Thomas A Ujas, Daimen R S Britsch, Katherine M Cotter, Katie Poinsatte, Ann M Stowe

B cells, also known as B lymphocytes or lymphoid lineage cells, are a historically understudied cell population with regard to brain-related injuries and diseases. However, an increasing number of publications have begun to elucidate the different phenotypes and roles B cells can undertake during central nervous system (CNS) pathology, including following ischemic and hemorrhagic stroke. B cell phenotype is intrinsically linked to function following stroke, as they may be beneficial or detrimental depending on the subset, timing, and microenvironment. Factors such as age, sex, and presence of co-morbidity also influence the behavior of post-stroke B cells. The following review will briefly describe B cells from origination to senescence, explore B cell function by integrating decades of stroke research, differentiate between the known B cell subtypes and their respective activity, discuss some of the physiological influences on B cells as well as the influence of B cells on certain physiological functions, and highlight the differences between B cells in healthy and disease states with particular emphasis in the context of ischemic stroke.

B细胞,也被称为B淋巴细胞或淋巴系细胞,是一个历史上未被充分研究的关于脑相关损伤和疾病的细胞群。然而,越来越多的出版物已经开始阐明B细胞在中枢神经系统(CNS)病理过程中的不同表型和作用,包括缺血性和出血性中风。B细胞表型与中风后的功能有着内在的联系,因为它们可能是有益的还是有害的,这取决于亚群、时间和微环境。年龄、性别、合并症等因素也会影响脑卒中后B细胞的行为。下面的综述将简要介绍B细胞从起源到衰老,通过整合几十年的卒中研究来探讨B细胞的功能,区分已知的B细胞亚型及其各自的活性,讨论对B细胞的一些生理影响以及B细胞对某些生理功能的影响,并强调B细胞在健康状态和疾病状态的差异,特别是在缺血性卒中的背景下。
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引用次数: 5
Regulatory T lymphocytes as a therapy for ischemic stroke. 调节性 T 淋巴细胞作为缺血性中风的一种疗法。
IF 7.9 2区 医学 Q1 IMMUNOLOGY Pub Date : 2023-05-01 Epub Date: 2022-12-05 DOI: 10.1007/s00281-022-00975-z
Miao Wang, Angus W Thomson, Fang Yu, Rimi Hazra, Aditi Junagade, Xiaoming Hu

Unrestrained excessive inflammatory responses exacerbate ischemic brain injury and impede post-stroke brain recovery. CD4+CD25+Foxp3+ regulatory T (Treg) cells play important immunosuppressive roles to curtail inflammatory responses and regain immune homeostasis after stroke. Accumulating evidence confirms that Treg cells are neuroprotective at the acute stage after stroke and promote brain repair at the chronic phases. The beneficial effects of Treg cells are mediated by diverse mechanisms involving cell-cell interactions and soluble factor release. Multiple types of cells, including both immune cells and non-immune CNS cells, have been identified to be cellular targets of Treg cells. In this review, we summarize recent findings regarding the function of Treg cells in ischemic stroke and the underlying cellular and molecular mechanisms. The protective and reparative properties of Treg cells endorse them as good candidates for immune therapy. Strategies that boost the numbers and functions of Treg cells have been actively developing in the fields of transplantation and autoimmune diseases. We discuss the approaches for Treg cell expansion that have been tested in stroke models. The application of these approaches to stroke patients may bring new hope for stroke treatments.

无节制的过度炎症反应会加重缺血性脑损伤,阻碍中风后大脑的恢复。CD4+CD25+Foxp3+ 调节性 T(Treg)细胞在中风后发挥重要的免疫抑制作用,抑制炎症反应,恢复免疫平衡。越来越多的证据证实,Treg 细胞在中风后的急性期具有神经保护作用,并在慢性期促进大脑修复。Treg 细胞的有益作用由多种机制介导,涉及细胞-细胞相互作用和可溶性因子释放。包括免疫细胞和非免疫中枢神经系统细胞在内的多种类型的细胞已被确定为 Treg 细胞的细胞靶标。在本综述中,我们总结了有关 Treg 细胞在缺血性中风中的功能及其潜在的细胞和分子机制的最新发现。Treg 细胞的保护和修复特性使其成为免疫疗法的理想候选者。移植和自身免疫性疾病领域一直在积极开发提高 Treg 细胞数量和功能的策略。我们讨论了在中风模型中测试的 Treg 细胞扩增方法。将这些方法应用于中风患者可能会为中风治疗带来新的希望。
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引用次数: 0
CAR T-cell behavior and function revealed by real-time imaging. 实时成像揭示CAR -t细胞的行为和功能。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-03-01 DOI: 10.1007/s00281-023-00983-7
David Espie, Emmanuel Donnadieu

Adoptive transfer of T-cells expressing chimeric antigen receptors (CAR) has shown remarkable clinical efficacy against advanced B-cell malignancies. Nonetheless, the field of CAR T-cells is currently facing several major challenges. In particular, the CAR T-cell strategy has not yet produced favorable clinical responses when targeting solid tumors. In this context, it is of paramount importance to understand the determinants that limit the efficacy of T-cell-based immunotherapy. Characterization of CAR T-cells is usually based on flow cytometry and whole-transcriptome profiling. These approaches have been very valuable to determine intrinsic elements that condition T-cell ability to proliferate and expand. However, they do not take into account spatial and kinetic aspects of T-cell responses. In particular, in order to control tumor growth, CAR T-cells need to enter into the tumor, migrate within a complex tumor environment, and form productive conjugates with their targets. Advanced imaging techniques combined with innovative preclinical models represent promising tools to uncover the dynamics of CAR T-cells. In this review, we will discuss recent results on the biology of engineered T-cells that have been obtained with real-time imaging microscopy. Important notions have emerged from these imaging-based studies, such as the multi-killing potential of CAR T-cells. Finally, we will highlight how imaging techniques combined with other tools can solve remaining unresolved questions in the field of engineered T-cells.

表达嵌合抗原受体(CAR)的t细胞过继转移治疗晚期b细胞恶性肿瘤显示出显著的临床疗效。尽管如此,CAR - t细胞领域目前面临着几个主要挑战。特别是,CAR - t细胞策略在针对实体肿瘤时尚未产生良好的临床反应。在这种情况下,了解限制t细胞免疫疗法疗效的决定因素至关重要。CAR -t细胞的表征通常基于流式细胞术和全转录组分析。这些方法对于确定制约t细胞增殖和扩张能力的内在因素非常有价值。然而,它们没有考虑到t细胞反应的空间和动力学方面。特别是,为了控制肿瘤生长,CAR - t细胞需要进入肿瘤,在复杂的肿瘤环境中迁移,并与靶标形成生产性偶联物。先进的成像技术与创新的临床前模型相结合,代表了揭示CAR - t细胞动力学的有希望的工具。在这篇综述中,我们将讨论利用实时成像显微镜获得的工程t细胞生物学的最新结果。从这些基于成像的研究中出现了重要的概念,例如CAR - t细胞的多重杀伤潜力。最后,我们将强调成像技术如何与其他工具相结合,可以解决工程t细胞领域仍未解决的问题。
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引用次数: 6
Tumor microenvironment antigens. 肿瘤微环境抗原。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-03-01 DOI: 10.1007/s00281-022-00966-0
Mads Hald Andersen

The identification and characterization of tumor antigens are central objectives in developing anti-cancer immunotherapy. Traditionally, tumor-associated antigens (TAAs) are considered relatively restricted to tumor cells (i.e., overexpressed proteins in tumor cells), whereas tumor-specific antigens (TSAs) are considered unique to tumor cells. Recent studies have focused on identifying patient-specific neoantigens, which might be highly immunogenic because they are not expressed in normal tissues. The opposite strategy has emerged with the discovery of anti-regulatory T cells (anti-Tregs) that recognize and attack many cell types in the tumor microenvironment, such as regulatory immune cells, in addition to tumor cells. The term proposed in this review is "tumor microenvironment antigens" (TMAs) to describe the antigens that draw this attack. As therapeutic targets, TMAs offer several advantages that differentiate them from more traditional tumor antigens. Targeting TMAs leads not only to a direct attack on tumor cells but also to modulation of the tumor microenvironment, rendering it immunocompetent and tumor-hostile. Of note, in contrast to TAAs and TSAs, TMAs also are expressed in non-transformed cells with consistent human leukocyte antigen (HLA) expression. Inflammation often induces HLA expression in malignant cells, so that targeting TMAs could additionally affect tumors with no or very low levels of surface HLA expression. This review defines the characteristics, differences, and advantages of TMAs compared with traditional tumor antigens and discusses the use of these antigens in immune modulatory vaccines as an attractive approach to immunotherapy. Different TMAs are expressed by different cells and could be combined in anti-cancer immunotherapies to attack tumor cells directly and modulate local immune cells to create a tumor-hostile microenvironment and inhibit tumor angiogenesis. Immune modulatory vaccines offer an approach for combinatorial therapy with additional immunotherapy including checkpoint blockade, cellular therapy, or traditional cancer vaccines. These combinations would increase the number of patients who can benefit from such therapeutic measures, which all have optimal efficiency in inflamed tumors.

肿瘤抗原的鉴定和表征是发展抗癌免疫治疗的中心目标。传统上,肿瘤相关抗原(TAAs)被认为相对局限于肿瘤细胞(即肿瘤细胞中的过表达蛋白),而肿瘤特异性抗原(TSAs)被认为是肿瘤细胞所特有的。最近的研究集中在确定患者特异性的新抗原,这可能是高度免疫原性的,因为它们在正常组织中不表达。随着抗调节性T细胞(anti-Tregs)的发现,相反的策略已经出现,这些细胞除了肿瘤细胞外,还能识别和攻击肿瘤微环境中的许多细胞类型,如调节性免疫细胞。在这篇综述中提出的术语是“肿瘤微环境抗原”(TMAs)来描述引起这种攻击的抗原。作为治疗靶点,tma具有与传统肿瘤抗原不同的优势。靶向tma不仅可以直接攻击肿瘤细胞,还可以调节肿瘤微环境,使其具有免疫能力和肿瘤敌意。值得注意的是,与TAAs和tsa相比,TMAs也在具有一致的人类白细胞抗原(HLA)表达的非转化细胞中表达。炎症往往会诱导恶性细胞中HLA的表达,因此靶向TMAs可以额外影响表面HLA表达水平不高或极低的肿瘤。本文综述了TMAs与传统肿瘤抗原的特点、差异和优势,并讨论了这些抗原在免疫调节疫苗中的应用,作为一种有吸引力的免疫治疗方法。不同的tma由不同的细胞表达,可以联合用于抗癌免疫疗法,直接攻击肿瘤细胞,调节局部免疫细胞,形成肿瘤敌对微环境,抑制肿瘤血管生成。免疫调节疫苗提供了一种与其他免疫疗法(包括检查点阻断、细胞疗法或传统癌症疫苗)联合治疗的方法。这些组合将增加从这些治疗措施中受益的患者数量,这些治疗措施对炎症性肿瘤都有最佳的疗效。
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引用次数: 16
Beyond direct killing-novel cellular immunotherapeutic strategies to reshape the tumor microenvironment. 除了直接杀伤外,还采用了新的细胞免疫治疗策略来重塑肿瘤微环境。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-03-01 Epub Date: 2022-09-27 DOI: 10.1007/s00281-022-00962-4
Duc Huynh, Pia Winter, Florian Märkl, Stefan Endres, Sebastian Kobold

The clinical use of cellular immunotherapies is gaining momentum and the number of approved indications is steadily increasing. One class of cellular therapies-chimeric antigen receptor (CAR)-modified T cells-has achieved impressive results in distinct blood cancer indications. These existing cellular therapies treating blood cancers face significant relapse rates, and their application beyond hematology has been underwhelming, especially in solid oncology. Major reasons for resistance source largely in the tumor microenvironment (TME). The TME in fact functionally suppresses, restricts, and excludes adoptive immune cells, which limits the efficacy of cellular immunotherapies from the onset. Many promising efforts are ongoing to adapt cellular immunotherapies to address these obstacles, with the aim of reshaping the tumor microenvironment to ameliorate function and to achieve superior efficacy against both hematological and solid malignancies.

细胞免疫疗法的临床应用势头越来越大,批准的适应症数量也在稳步增加。一类细胞疗法——嵌合抗原受体(CAR)修饰的T细胞——在不同的血液癌症适应症中取得了令人印象深刻的结果。这些现有的治疗血癌的细胞疗法面临着显著的复发率,它们在血液学之外的应用一直不尽如人意,尤其是在实体肿瘤学中。耐药性主要来源于肿瘤微环境(TME)。TME实际上在功能上抑制、限制和排斥过继免疫细胞,这从一开始就限制了细胞免疫疗法的疗效。许多有希望的努力正在进行中,以适应细胞免疫疗法来解决这些障碍,目的是重塑肿瘤微环境,改善功能,并对血液系统和实体恶性肿瘤达到卓越的疗效。
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引用次数: 6
期刊
Seminars in Immunopathology
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