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NK cell-mediated tumor cell destruction is a complex biological process, not a single molecular target. It represents the mechanism by which natural killer cells recognize and eliminate transformed cells through multiple coordinated pathways[1][2].\n\nThe process involves several key molecular mechanisms: First, NK cells form an immunological synapse with target tumor cells through receptor-ligand interactions and adhesion molecules, particularly LFA-1 integrin[1]. Second, cytotoxic granules containing perforin and granzymes are polarized and released at the synapse. Perforin forms pores in the target cell membrane, allowing granzymes to enter and induce apoptosis[2][3]. Third, death ligands such as FAS ligand can activate death receptors on tumor cells, initiating alternative apoptotic pathways[1][4]. Fourth, antibody-dependent cell-mediated cytotoxicity (ADCC) occurs when NK cells recognize antibody-coated tumor cells via CD16 receptors[3][4].\n\nActual therapeutic targets within this process that could be therapeutically modulated include: NK cell activating receptors (NKG2D, NCRs), inhibitory receptors (KIRs), CD16 (FcγRIII), perforin, granzymes, death ligands (FAS ligand, TRAIL), and various signaling molecules involved in granule exocytosis (Munc13-4, syntaxin 11, Rab27a)[1][2].
Enhancement of NK cell cytotoxicity through ADCC, checkpoint inhibition, or direct NK cell activation
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