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The Wilms' tumor 1 (WT1) protein is a zinc-finger transcription factor that is highly overexpressed in a variety of hematological malignancies and solid tumors, while maintaining very low expression in normal adult tissues (Cheever et al., 2009, PMID: 19723909). Intracellular WT1 protein is processed by the proteasome into short peptide fragments, which are then transported to the endoplasmic reticulum and loaded onto Major Histocompatibility Complex (MHC) Class I molecules. The specific complex formed by a WT1-derived peptide (such as the RMFPNAPYL or SLGEQQYSV sequences) and the HLA-A*02:01 allele is presented on the cell surface, acting as a "red flag" for the immune system (Oka et al., 2004, PMID: 14710020). This peptide-MHC complex is a primary target for various immunotherapeutic strategies, including TCR-engineered T-cell (TCR-T) therapies, peptide-based vaccines, and TCR-like monoclonal antibodies (Dao et al., 2013, PMID: 23486626). These therapies aim to exploit the differential expression of WT1 to selectively eliminate cancer cells while minimizing damage to healthy tissues.
The mechanism involves the recognition of the specific WT1 peptide/HLA-A*02:01 complex by either endogenous T cells (stimulated by vaccines) or engineered T cells (TCR-T), leading to the formation of an immunological synapse and subsequent release of perforins and granzymes to induce apoptosis in the target cell (Schmitt et al., 2013, PMID: 23319793).
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