Programmed death-ligand 1 (PD-L1), also well-known as B7-H1 and CD274, is a protein that acts as a kind of 'brake' to keep the body's immune responses under control. PD-L1 may be found on some normal cells and in higher-than-normal amounts on some types of cancer cells. When PD-L1 binds to programmed death-1 (PD-1, also known as CD279 and PDCD1), a protein found on T cells, it keeps T cells from killing the PD-L1-containing cells, including the cancer cells. Anticancer drugs called immune checkpoint inhibitors bind to PD-L1 and block its binding to PD-1. This releases the 'brakes' on the immune system and leaves T cells free to kill cancer cells.
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PD-1 is involved in immune tolerance by suppressing activated immune cells via interaction with its ligands. Two known ligands of PD-1 are PD-L1 and PD-L2. PD-L1 is a 290 aa transmembrane glycoprotein. PD-L2 may lead to local cytokine production that is beneficial to the tumor cells. PD-L1 and PD-L2 play different roles in the immune regulatory process. PD-L1 inhibits T-cell function in peripheral tissues, whereas PD-L2 suppresses immune T-cell activation in lymphoid organs.
The PD-1/PD-L1 pathway represents an adaptive immune resistance mechanism exerted by tumor cells in response to endogenous immune anti-tumor activity. PD-L1 is overexpressed on tumor cells or non-transformed cells in the tumor microenvironment. The binding of PD-L1 to PD-1 leads to the inhibition of the cytotoxic T cells. These deactivated T cells remain inhibited in the tumor microenvironment.
Fig.1. Identification of PD-1/PD-L1.1,2
The monoclonal antibody (mAb) therapies against PD-1 and PD-L1 are routinely used for immunotherapy. The efficiency of the immune checkpoint blockade with mAbs in cancer treatment is remarkable, but not all patients respond to a single therapy. To enhance and broaden the anti-tumor activity of immune checkpoint inhibition, one possible solution is combinational immunotherapy. An example of this is the success of the combination of PD-1/PD-L1 inhibition blockage with complementary checkpoint inhibitor CTLA-4 in melanoma and non-small cell lung cancer.
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