翻译后修饰介导的膜表面稳态调控与胶质母细胞瘤免疫可见性重塑
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南京医科大学第一附属医院神经外科

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Post-translational Modification-mediated Regulation of Membrane Surface Homeostasis and Immune Visibility Remodeling in Glioblastoma
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Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing,210029

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    摘要:

    胶质母细胞瘤(Glioblastoma,GBM)对免疫治疗总体反应有限,传统基于程序性死亡配体1(programmed death ligand 1,PD-L1)、主要组织相容性复合体Ⅰ类分子(major histocompatibility complex class I,MHC-I)、分化簇47(cluster of differentiation 47,CD47)等免疫相关分子表达水平的解释,尚难以充分揭示其免疫逃逸和治疗抵抗机制。研究表明,GBM免疫逃逸不仅取决于这些分子的表达丰度,还与其翻译后修饰介导的膜表面稳态调控密切相关,包括蛋白成熟、质膜递送、膜表面驻留、内吞回收、降解分流及细胞外囊泡输出等动态过程。在这一框架下,“免疫可见性”可被理解为肿瘤细胞及其释放的细胞外囊泡在特定时空背景下可被免疫系统识别、接触、杀伤或吞噬的功能性表面状态。综述重点阐述PD-L1、MHC-I、CD47及细胞外囊泡在GBM中调控适应性免疫逃逸、先天免疫逃逸和分布式免疫抑制的机制,并评估其作为动态生物标志物和联合治疗靶点的转化潜力。该理论框架提示,GBM精准免疫治疗研究应由静态表达检测转向膜表面可用性、翻译后修饰状态及囊泡输出特征的综合评估,并进一步关注蛋白成熟、转运、稳定性维持及囊泡释放等上游调控节点的机制导向干预策略。

    Abstract:

    Glioblastoma (GBM) exhibits limited response to immunotherapy, and conventional explanations based on the expression levels of immune-related molecules such as programmed death ligand 1 (PD-L1), major histocompatibility complex class I (MHC-I), and cluster of differentiation 47 (CD47) have proven insufficient to fully elucidate its immune evasion and therapy resistance mechanisms. Evidence indicates that GBM immune escape depends not only on the abundance of these molecules but also on their post-translational modification (PTM)-mediated regulation of membrane surface homeostasis, including protein maturation, plasma membrane delivery, surface retention, endocytic recycling, degradation, and extracellular vesicle (EV) export. Within this framework, “immune visibility” can be defined as the functional surface state in which tumor cells and their released EVs are recognizable, accessible, and susceptible to immune detection, engagement, killing, or phagocytosis in specific spatial and temporal contexts. This review emphasizes the regulatory roles of PD-L1, MHC-I, CD47, and EVs in adaptive immune evasion, innate immune escape, and distributed immunosuppression in GBM, and evaluates their translational potential as dynamic biomarkers and targets for combination therapy. The proposed framework suggests that precision immunotherapy research in GBM should shift from static expression assessment to integrated evaluation of membrane surface availability, PTM status, and EV-mediated output, while further addressing upstream regulatory nodes that govern protein maturation, trafficking, stability, and vesicle release for mechanism-based therapeutic interventions.

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  • 收稿日期:2026-05-08
  • 最后修改日期:2026-07-06
  • 录用日期:2026-09-03
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