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Fig. 1 | BMC Medicine

Fig. 1

From: Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis

Fig. 1

Mechanism of action: CTLA-4 and anti-CTLA-4 antibodies. Two signals are required to initiate an immune response. For the first signal (signal 1), tumor associated antigen (Ag), is presented by major histocompatibility complex (MHC) on antigen presenting cell (APC) and recognized by the toll-like receptor (TCR) of T-cell. Signal 2 occurs in response to binding of CD80 or CD86 (B7) on APC cell with CD28 receptor on T-cell (a). CTLA-4 is a homolog of CD28 and limits proliferative response of activated T-cell competing with CD28 for ligand B7. This inhibition occurs in response to binding of CD80 or CD86 on APC with CTLA-4 receptor on T-cell and interrupts signal 2 (b). Anti-CTLA-4 antibodies blocks CTLA-4 and enhances T-cell activation and proliferation (c)

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