Page 128 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第46卷第9期
·1398 · Journal of Nanjing Medical University（Natural Sciences） 2026年9月

·综 述·

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

孟明辉，陈正新，王慧博 *

南京医科大学第一附属医院神经外科，江苏 南京 210029

［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 differentia⁃
tion 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。论文重点阐述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对膜表面可用性、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导向干预策略。
［关键词］ 胶质母细胞瘤；免疫可见性；翻译后修饰；膜表面稳态调控；免疫逃逸；细胞外囊泡
［中图分类号］ R739.41 ［文献标志码］ A ［文章编号］ 1007⁃4368（2026）09⁃1398⁃14
doi：10.7655/NYDXBNSN260571

Post ⁃ translational modification ⁃ mediated regulation of membrane surface homeostasis
and immune visibility remodeling in glioblastoma
MENG Minghui，CHEN Zhengxin，WANG Huibo *
Department of Neurosurgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［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.
［Key words］ glioblastoma；immune visibility；post⁃translational modification；membrane surface homeostasis regulation；immune
evasion；extracellular vesicle
［J Nanjing Med Univ，2026，46（09）：1398⁃1411］
［基金项目］ 国家自然科学基金（82573129）
通信作者（Corresponding author），E⁃mail： hbwang@njmu.edu.cn（ORCID：0000⁃0001⁃8062⁃4873）
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