Multipl miyelom’da CD4+ regülatör T hücrelerin rolü

Yapılan pek çok araştırmada hem yeni tanı multipl miyelomda hem de otolog kök hücre nakli dahil kemoterapötik tedaviler sonrası hastalarda regülatör T hücrelerin artışı söz konusudur. Multipl miyelom habis bir plazma hücre hastalığıdır. Regülatör T hücreleri kanser ve inflamatuar koşullardan otoimmün hastalıklara kadar immün homeostazide rol oynar. PD-1 yolağı yardımcı T hücre popülasyonunu regülatör T hücre gelişimi yönünde uyarmaktadır. PDL1'in indüklenebilir regülatör T hücrelerin farklılaştırılmasında önemli bir rol oynadığı gösterilmiştir. Son zamanlarda multipl miyelomda PDL1 veya PD-1'i hedef alan en az altı klinik çalışma başlatılmıştır. Mevcut literatüre göre miyelom hastalarının anti PD-1/PDL1 tedavisinden fayda sağlayabileceğini önermekteyiz.

Role of CD4+ regulatory T cells in multiple myeloma

In many studies, regulatory T cell increase is seen both in patients with newly diagnosed multiple myeloma and post chemotherapy patients including autologous stem cell transplants. Multiple myeloma is a malignant plasma cell disease. Regulatory T cells have a role in immune homeostasis from cancer and inflamatory conditions to autoimmune diseases. PD-1 pathway stimulates T cell population towards regulatory T cell development. It has been shown that PDL1 plays an important role in differentiating inducable regulatory T cells. Recently, at least six clinical studies targeting PDL1 or PD-1 on multiple myeloma have been started. In accordance with the current literature, we suggest that patients with myeloma can benefit anti PD-1/PDL1 therapy.

Keywords:

PD-1/PDL1-PDL2, Multiple myeloma regulatory T cells, PD-1/PDL1-PDL2,

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