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. Author manuscript; available in PMC: 2016 Jun 28.
Published in final edited form as: Immunotherapy. 2015 Aug 28;7(8):923–939. doi: 10.2217/imt.15.57

Table 1.

Selected pathways for immune modulation and homeostasis.

Pathway Comment
T-cell activation checkpoints:
  • -

    PD–1–PDL1

  • -

    CTLA4–CD80/86

  • -

    KIR–MHC

  • -

    LAG3–MHC

  • -

    TIM3–Gal9

  • -

    BTLA–HVEM

  • -

    NKG2A–HLA–E

The first element in each pair of this category except NKG2A is located on the T cell,
and ligand interaction results in direct down-regulatory cell signaling in the T cell [17].
NKG2A is the ligand for HLA-E and down regulates NK-cell activity [22]
T-cell activation stimulators:
  • -

    CD–27–CD70

  • -

    CD–28–CD80/86

  • -

    CD40L–CD40

  • -

    GITR–GITRL

  • -

    CD137–41BBL

  • -

    CD134–OX40L

  • -

    ICOS–B7RP1

The first element of the pair in this activator list is on the T cell. Ligand binding
promotes T-cell activation, except for CD40L which stimulates APC leading to indirect
T-cell activation [17]
Pathogen associated molecular
patterns:
  • -

    Toll-like receptor family

  • -

    Nucleic acid-TLR3,7,8,9

  • -

    LPS–TLR4

  • -

    Flagellin–TLR5

  • -

    Lipopeptides–TLR1,2

A primary interface between intrinsic and adaptive immunity is mediated by
recognition by local cells of foreign materials. Characteristic molecular patterns
including microbial DNA/RNA, microbial cell wall elements and microbial glycolipid
structures bind these receptors and trigger immune stimulator cytokine activation [23].
Toll-like receptor agonists may be useful for combination with immune modulatory
antibodies
Metabolic T-cell modulators:
  • -

    A2aR–adenosine

  • -

    indoleamine oxidase

Adenosine accumulates at the site of cell death and is stimulatory to Treg cells, thus
down regulating inflammatory sites [24]. Tryptophan is a needed amino acid for T-cell
growth, indoleamine oxidase metabolizes tryptophan and is overexpressed in tumors
facilitating immune escape [25]
Cell types with immune-modulatory
function:
  • -

    Plasmacytoid dendritic cells

  • -

    Regulatory T cells

  • -

    Myeloid derived suppressor cells

  • -

    Macrophage

  • -

    Mast Cell

  • -

    Fibroblasts

Many cells involved in coordinating a primary immune response and facilitating
healing are capable of producing inflammation limiting cytokines, promoting
angiogenesis, collagen synthesis and scar tissue formation. Tumors can find growth
advantage by expressing factors that favor a ‘healing microenvironment’. These cell
types thus can be tumor promoting in states of chronic inflammatory wound healing
but can also mediate antitumor effects when armed with a specific antibody [26,27]
Immune stimulatory cytokines:
  • -

    IL-1

  • -

    IFN-α

  • -

    TNF-α

  • -

    IL-6,

  • -

    IL-12

  • -

    IL-18

A few select cytokines that are central to activating an immune response and
favoring cell-mediated T-cell immunity are listed here; however many other cytokines
influence the immune balance and may be highly relevant to effective cancer
immunotherapy [28]
Immune suppressive cytokines:
  • -

    TGF-β,

  • -

    IL-10

There are many other factors and cytokines that also influence the balance of
immunity, however IL-10 and TGF-β are especially well characterized in this regard [28]
Effector cell chemokines:
  • -

    MCP-1

  • -

    CCL5

  • -

    CCL10

Chemokines facilitate local accumulation of effector cells including activated T cells,
NK cells and inflammatory monocytes [21]
Suppressor cell chemokines:
  • -

    CCL22

CCL22 is locally chemotactic to Tregs; there are other chemokines that are chemotactic
to immune-regulatory cell phenotypes that may also be targets [21]