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目的:总结可增强光动力疗法(PDT)抗肿瘤免疫效应的相关治疗研究进展。方法:应用PubMed和CNKI数据库,以“光动力疗法、肿瘤、免疫疗法、靶向光敏剂、肿瘤疫苗和免疫抑制”等为关键词,检索2000-01-2011-08的相关文献。纳入标准:1)PDT联合的免疫疗法;2)靶向光敏剂;3)PDT光照剂量;4)PDT免疫抑制效应;5)PDT肿瘤疫苗。排除重复研究与本研究无关的文献,符合分析的文献32篇。结果:PDT处理后对宿主免疫系统的影响极为复杂,既能促进抗肿瘤免疫,在某些情况下又能抑制免疫;PDT联合免疫佐剂、细胞因子或免疫细胞可有效增强PDT抗肿瘤免疫反应;疫抑制效应具有条件性,可通过制备靶向光敏剂、调节光照剂量和去除负向调节性免疫效应分子及调节性T细胞等多种途径减弱甚至去除这种生物效应;PDT处理后肿瘤细胞裂解物具有免疫刺激作用,可用作肿瘤疫苗。结论:联合免疫疗法或其他方法来增强PDT抗肿瘤免疫效应、拮抗免疫抑制效应,可显著提高PDT抗肿瘤疗效。
OBJECTIVE: To summarize the progress of the related therapies that can enhance the anti-tumor immune effect of photodynamic therapy (PDT). METHODS: Using the PubMed and CNKI databases, the key words of “Photodynamic Therapy, Tumors, Immunotherapy, Targeted Photosensitizers, Tumor Vaccines and Immunosuppression” were searched for relevant articles from 2000-01-2011-08. Inclusion criteria: 1) PDT combined immunotherapy; 2) targeted photosensitizer; 3) PDT light dose; 4) PDT immunosuppressive effect; 5) PDT tumor vaccine. Excluding duplicate studies unrelated to this study, 32 papers were analyzed. Results: The effect of PDT on host immune system was extremely complex, which not only promoted anti-tumor immunity but also inhibited the immune in some cases. PDT combined with immune adjuvant, cytokines or immune cells could effectively enhance the anti-tumor immune response of PDT ; The inhibitory effect of the disease is conditional, and the biological effects can be attenuated or even eliminated by preparing the target photosensitizer, adjusting the light dose, removing the negative regulatory immune effector molecules and the regulatory T cells, and the biological effects of PDT-treated tumor cells Lysates have an immunostimulating effect and are useful as tumor vaccines. Conclusions: Combined immunotherapy or other methods to enhance the anti-tumor immune effect of PDT and antagonize the immunosuppressive effect can significantly improve the anti-tumor efficacy of PDT.