Evidence map›Paper›PMID 42195030›Full record

ReviewGenes2026

The CTLA-4 Pathway in Human Disease: Molecular Mechanisms and Therapeutic Targeting.

Simone Negrini, Stefania Nicola, Iuliana Badiu, Anna Quinternetto, Ilaria Vitali, Luca Lo Sardo, Luisa Brussino

Abstract readReview
In one paragraph

Review in Genes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Simone NegriniDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.ORCID 0000-0003-1267-4320
Stefania NicolaDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.
Iuliana BadiuDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.ORCID 0000-0001-8364-6023
Anna QuinternettoDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.ORCID 0000-0001-7679-2372
Ilaria VitaliDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.
Luca Lo SardoDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.
Luisa BrussinoDepartment of Medical Sciences, University of Turin, 10124 Turin, Italy.ORCID 0000-0001-7249-7616

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesCTLA-4 is a key checkpoint of peripheral immune regulation, yet its biology cannot be reduced to inhibitory signaling alone. This review discusses CTLA-4 as a dynamic regulatory pathway shaped by ligand handling, intracellular trafficking, recycling, and cell-type-specific function, and examines how these features link molecular mechanism to human disease and therapy.

methodsWe synthesized the structural, mechanistic, translational, and clinical literature spanning CTLA-4 molecular biology, cell-type-specific function, inborn errors of immunity, polygenic autoimmunity, transplantation, cancer immunotherapy, and immune-related adverse events.

resultsCTLA-4 function depends on surface availability, trans-endocytosis of CD80/CD86, and tight control of endosomal trafficking. These features help explain why CTLA-4 haploinsufficiency, LRBA deficiency, and DEF6 deficiency converge clinically despite different upstream lesions, and why subtler CTLA-4 variation contributes to polygenic autoimmunity. Therapeutic studies also provide mechanistic insight. Abatacept can partly replace pathway function in monogenic disease, whereas belatacept highlights the limits of ligand blockade when endogenous coinhibition is also lost. In oncology, anti-CTLA-4 antibodies act through a more complex interplay involving checkpoint blockade, Fc biology, intratumoral Treg depletion, and receptor recycling. Emerging next-generation agents aim to retain antitumor activity while reducing systemic toxicity through more selective use of these mechanisms.

conclusionsRather than a static inhibitory receptor, CTLA-4 is better viewed as a context-dependent regulatory pathway whose function depends on trafficking, surface availability, and cellular context. This perspective links molecular mechanism to clinical phenotype and supports more precise CTLA-4-targeted therapy.

Indexed as

CTLA-4 AntigenAnimalsAutoimmunityHumansImmunotherapyNeoplasmsSignal TransductionCTLA-4 AntigenCTLA4 protein, humancheckpoint inhibitionCTLA-4CTLA-4 insufficiencyimmune regulationimmunotherapyLRBA deficiencyregulatory T cellstrans-endocytosis

Identifiers

PMID42195030
PMCPMC13205506

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.