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<h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Kostimulator</span></h1>
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<div id="mw-content-text" class="mw-body-content mw-content-ltr" lang="de" dir="ltr"><div class="mw-content-ltr mw-parser-output" lang="de" dir="ltr"><p>Ein <b>Kostimulator</b> (synonym <i>kostimulatorisches Molekül</i>) ist ein <a href="Protein" title="Protein">Protein</a>, das als zweiter <a href="Rezeptor_(Biochemie)" title="Rezeptor (Biochemie)">Rezeptor</a> aktiviert werden muss, um eine <a href="Adaptive_Immunantwort" class="mw-redirect" title="Adaptive Immunantwort">adaptive Immunantwort</a> auszulösen.
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<div class="mw-heading mw-heading2"><h2 id="Eigenschaften">Eigenschaften</h2></div>
<p>Die adaptive Immunantwort entsteht durch <a href="Antigenpr%C3%A4sentation" title="Antigenpräsentation">Antigenpräsentation</a> gegenüber dem <a href="B-Zell-Rezeptor" title="B-Zell-Rezeptor">B-Zell-Rezeptor</a> (BCR) auf <a href="B-Zellen" class="mw-redirect" title="B-Zellen">B-Zellen</a> und auf dem <a href="Haupthistokompatibilit%C3%A4tskomplex" title="Haupthistokompatibilitätskomplex">Haupthistokompatibilitätskomplex</a> (MHC) gegenüber dem <a href="T-Zell-Rezeptor" title="T-Zell-Rezeptor">T-Zell-Rezeptor</a> (TCR) von <a href="T-Zellen" class="mw-redirect" title="T-Zellen">T-Zellen</a>. Eine Aktivierung erfolgt nur, wenn gleichzeitig ein zweiter Rezeptor aus der Gruppe der Kostimulatoren aktiviert wird. Bei einer Aktivierung des BCR oder TCR ohne Aktivierung eines Kostimulators entsteht eine <a href="Anergie" title="Anergie">Anergie</a>.
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<div class="mw-heading mw-heading3"><h3 id="B-Zellen">B-Zellen</h3></div>
<p>Beispiele für Kostimulatoren bei B-Zellen sind <a href="CD40" class="mw-redirect" title="CD40">CD40</a> und sein <a href="Ligand_(Biochemie)" title="Ligand (Biochemie)">Ligand</a> CD40L,<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> oder <a href="Komplementrezeptor_2" title="Komplementrezeptor 2">CR2</a> und einer seiner Liganden iC3b, C3dg oder C3d.<sup id="cite_ref-Frank_2-0" class="reference"><a href="#cite_note-Frank-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading3"><h3 id="T-Zellen">T-Zellen</h3></div>
<p>Kostimulatoren bei T-Zellen sind <a href="CD28" class="mw-redirect" title="CD28">CD28</a> und seine Liganden <a href="B7-1" title="B7-1">B7-1</a> und <a href="B7-2" title="B7-2">B7-2</a>,<sup id="cite_ref-Parham_3-0" class="reference"><a href="#cite_note-Parham-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> sowie <a href="ICOS" class="mw-redirect" title="ICOS">ICOS</a> und sein Ligand ICOSL (synonym <i>B7-H2</i>).<sup id="cite_ref-Coico_4-0" class="reference"><a href="#cite_note-Coico-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Die Bindung von CD28 wird kompetitiv durch den immunsupprimierenden Rezeptor <a href="CTLA-4" title="CTLA-4">CTLA-4</a> gehemmt.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>
</p><p>Manche <a href="Superantigen" title="Superantigen">Superantigene</a> binden gleichzeitig an den TCR und an den Kostimulator CD28, wodurch beide notwendigen Signale für eine Aktivierung der T-Zelle vermittelt werden.<sup id="cite_ref-Sastalla_8-0" class="reference"><a href="#cite_note-Sastalla-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading2"><h2 id="Anwendungen">Anwendungen</h2></div>
<p><a href="Abatacept" title="Abatacept">Abatacept</a> und Belatacept sind jeweils <a href="Fusionsprotein" title="Fusionsprotein">Fusionsproteine</a> aus der <a href="Fc-Fragment" class="mw-redirect" title="Fc-Fragment">Fc-Region</a> von <a href="IgG" class="mw-redirect" title="IgG">IgG</a>1 mit dem extrazellulären Anteil von <a href="CTLA4" class="mw-redirect" title="CTLA4">CTLA4</a>, die an B7-Proteine binden und die Kostimulation von T-Zellen unterbinden.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Abatacept wird zur Behandlung der <a href="Autoimmunerkrankung" title="Autoimmunerkrankung">Autoimmunerkrankung</a> <a href="Rheumatoide_Arthritis" title="Rheumatoide Arthritis">rheumatoide Arthritis</a> eingesetzt. Belatacept wird zur Vermeidung einer <a href="Absto%C3%9Fungsreaktion" class="mw-redirect" title="Abstoßungsreaktion">Abstoßungsreaktion</a> nach einer <a href="Nierentransplantation" title="Nierentransplantation">Nierentransplantation</a> verwendet. Eine Hemmung von Kostimulatoren wird zur Behandlung der Autoimmunerkrankung <a href="Lupus_erythematodes" title="Lupus erythematodes">Lupus erythematodes</a> untersucht.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Weiterhin wird eine Hemmung von Kostimulatoren zur Behandlung von organspezifischen Autoimmunerkrankungen wie <a href="Multiple_Sklerose" title="Multiple Sklerose">Multiple Sklerose</a> und <a href="Diabetes_mellitus" title="Diabetes mellitus">Diabetes mellitus</a> Typ 1 untersucht.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading2"><h2 id="Einzelnachweise">Einzelnachweise</h2></div>
<ol class="references">
<li id="cite_note-1"><span class="mw-cite-backlink"><a href="#cite_ref-1">↑</a></span> <span class="reference-text">V. Seda, M. Mraz: <i>B-cell receptor signalling and its crosstalk with other pathways in normal and malignant cells.</i> In: <i>European journal of haematology.</i> Band 94, Nummer 3, März 2015, S. 193–205, <a href="https://doi.org/10.1111/ejh.12427" class="extiw external" title="doi:10.1111/ejh.12427">doi:10.1111/ejh.12427</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/25080849?dopt=Abstract">PMID 25080849</a>.</span>
</li>
<li id="cite_note-Frank-2"><span class="mw-cite-backlink"><a href="#cite_ref-Frank_2-0">↑</a></span> <span class="reference-text">K. Frank, J. P. Atkinson: <i>Complement system.</i> In: Austen KF, Frank K, Atkinson JP, Cantor H. eds. <i>Samter’s Immunologic Diseases, 6th ed. Vol. 1,</i> Philadelphia: Lippincott Williams & Wilkins, 2001. ISBN 0-7817-2120-2. S. 281–298.</span>
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<li id="cite_note-Parham-3"><span class="mw-cite-backlink"><a href="#cite_ref-Parham_3-0">↑</a></span> <span class="reference-text">Peter Parham: <i>The Immune System, Fourth Edition.</i> Garland Science, 2014, ISBN 978-1-317-51157-1, S. 211.</span>
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<li id="cite_note-Coico-4"><span class="mw-cite-backlink"><a href="#cite_ref-Coico_4-0">↑</a></span> <span class="reference-text">Richard Coico: <i>Immunology.</i> John Wiley & Sons, 2015, ISBN 978-1-118-39690-2.</span>
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<li id="cite_note-5"><span class="mw-cite-backlink"><a href="#cite_ref-5">↑</a></span> <span class="reference-text">M. L. Ford, A. B. Adams, T. C. Pearson: <i>Targeting co-stimulatory pathways: transplantation and autoimmunity.</i> In: <i>Nature reviews. Nephrology.</i> Band 10, Nummer 1, Januar 2014, S. 14–24, <a href="https://doi.org/10.1038/nrneph.2013.183" class="extiw external" title="doi:10.1038/nrneph.2013.183">doi:10.1038/nrneph.2013.183</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/24100403?dopt=Abstract">PMID 24100403</a>, <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365450/">PMC 4365450</a> (freier Volltext).</span>
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<li id="cite_note-6"><span class="mw-cite-backlink"><a href="#cite_ref-6">↑</a></span> <span class="reference-text">L. Chen, D. B. Flies: <i>Molecular mechanisms of T cell co-stimulation and co-inhibition.</i> In: <i><a href="Nature_Reviews_Immunology" title="Nature Reviews Immunology">Nature Reviews Immunology</a>.</i> Band 13, Nummer 4, April 2013, S. 227–242, <a href="Digital_Object_Identifier" title="Digital Object Identifier">doi</a>:<span class="uri-handle" style="white-space:nowrap"><a rel="nofollow" class="external text" href="https://doi.org/10.1038/nri3405">10.1038/nri3405</a></span>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/23470321?dopt=Abstract">PMID 23470321</a>, <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786574/">PMC 3786574</a> (freier Volltext).</span>
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<li id="cite_note-7"><span class="mw-cite-backlink"><a href="#cite_ref-7">↑</a></span> <span class="reference-text">N. Beyersdorf, T. Kerkau, T. Hünig: <i>CD28 co-stimulation in T-cell homeostasis: a recent perspective.</i> In: <i>ImmunoTargets and therapy.</i> Band 4, 2015, S. 111–122, <a href="Digital_Object_Identifier" title="Digital Object Identifier">doi</a>:<span class="uri-handle" style="white-space:nowrap"><a rel="nofollow" class="external text" href="https://doi.org/10.2147/ITT.S61647">10.2147/ITT.S61647</a></span>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/27471717?dopt=Abstract">PMID 27471717</a>, <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918251/">PMC 4918251</a> (freier Volltext).</span>
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<li id="cite_note-Sastalla-8"><span class="mw-cite-backlink"><a href="#cite_ref-Sastalla_8-0">↑</a></span> <span class="reference-text">Inka Sastalla: <i>Bacterial Exotoxins: How Bacteria Fight the Immune System.</i> Frontiers Media SA, 2016, ISBN 978-2-88919-991-4, S. 155.</span>
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<li id="cite_note-9"><span class="mw-cite-backlink"><a href="#cite_ref-9">↑</a></span> <span class="reference-text">L. Moreland, G. Bate, P. Kirkpatrick: <i>Abatacept.</i> In: <i>Nature reviews. Drug discovery.</i> Band 5, Nummer 3, 03 2006, S. 185–186, <a href="https://doi.org/10.1038/nrd1989" class="extiw external" title="doi:10.1038/nrd1989">doi:10.1038/nrd1989</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/16557658?dopt=Abstract">PMID 16557658</a>.</span>
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<li id="cite_note-10"><span class="mw-cite-backlink"><a href="#cite_ref-10">↑</a></span> <span class="reference-text">P. Masson, L. Henderson, J. R. Chapman, J. C. Craig, A. C. Webster: <i>Belatacept for kidney transplant recipients.</i> In: <i>The Cochrane database of systematic reviews.</i> Nummer 11, November 2014, S. CD010699, <a href="https://doi.org/10.1002/14651858.CD010699.pub2" class="extiw external" title="doi:10.1002/14651858.CD010699.pub2">doi:10.1002/14651858.CD010699.pub2</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/25416857?dopt=Abstract">PMID 25416857</a>.</span>
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<li id="cite_note-11"><span class="mw-cite-backlink"><a href="#cite_ref-11">↑</a></span> <span class="reference-text">M. L. Ford, A. B. Adams, T. C. Pearson: <i>Targeting co-stimulatory pathways: transplantation and autoimmunity.</i> In: <i>Nature reviews. Nephrology.</i> Band 10, Nummer 1, Januar 2014, S. 14–24, <a href="https://doi.org/10.1038/nrneph.2013.183" class="extiw external" title="doi:10.1038/nrneph.2013.183">doi:10.1038/nrneph.2013.183</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/24100403?dopt=Abstract">PMID 24100403</a>, <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365450/">PMC 4365450</a> (freier Volltext).</span>
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<li id="cite_note-12"><span class="mw-cite-backlink"><a href="#cite_ref-12">↑</a></span> <span class="reference-text">Q. Zhang, D. A. Vignali: <i>Co-stimulatory and Co-inhibitory Pathways in Autoimmunity.</i> In: <i>Immunity.</i> Band 44, Nummer 5, Mai 2016, S. 1034–1051, <a href="https://doi.org/10.1016/j.immuni.2016.04.017" class="extiw external" title="doi:10.1016/j.immuni.2016.04.017">doi:10.1016/j.immuni.2016.04.017</a>, <a class="external mw-magiclink-pmid" rel="nofollow" href="https://www.ncbi.nlm.nih.gov/pubmed/27192568?dopt=Abstract">PMID 27192568</a>, <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873959/">PMC 4873959</a> (freier Volltext).</span>
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