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CTLA-4 blockade shifts the B cell repertoire toward autoimmunity.

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The Journal of clinical investigation 📖 저널 OA 99.2% 2021: 1/1 OA 2023: 1/1 OA 2024: 1/1 OA 2025: 51/51 OA 2026: 66/67 OA 2021~2026 2025 Vol.135(22)
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Çakan E, Wang M, Dai Y, Mirouse A, Villanueva-Pachas CR, Bouis D

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Checkpoint inhibitors targeting CTLA-4 and PD-1 revolutionized the treatment of cancer patients, but their use is limited by the emergence of immune-related adverse events (irAEs).

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APA Çakan E, Wang M, et al. (2025). CTLA-4 blockade shifts the B cell repertoire toward autoimmunity.. The Journal of clinical investigation, 135(22). https://doi.org/10.1172/JCI189074
MLA Çakan E, et al.. "CTLA-4 blockade shifts the B cell repertoire toward autoimmunity.." The Journal of clinical investigation, vol. 135, no. 22, 2025.
PMID 41026527 ↗
DOI 10.1172/JCI189074

Abstract

Checkpoint inhibitors targeting CTLA-4 and PD-1 revolutionized the treatment of cancer patients, but their use is limited by the emergence of immune-related adverse events (irAEs). We assessed autoreactive B cell frequencies in the blood of cancer patients before and after treatment with checkpoint inhibitors by testing the reactivity of recombinant antibodies cloned from single B cells. We found that anti-PD-1 and anti-CTLA-4 combination therapy induced the emergence of autoreactive mature naive B cells, whereas central B cell tolerance remained functional. In contrast, anti-PD-1 alone did not alter autoreactive B cell counterselection. Anti-CTLA-4 injections in humanized mice also resulted in the production of autoreactive B cells, whereas anti-PD-1 did not. We conclude that CTLA-4 but not PD-1 is required for the removal of developing autoreactive mature naive B cells and that CTLA-4 blockade broadens the peripheral B cell repertoire, which likely contains clones that promote not only irAEs but also antitumor responses.

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