Potential beneficial effects of PD-1/PD-L1 blockade in Alzheimer’s disease: A systematic review and meta-analysis of preclinical and clinical studies

Programmed cell death-1 (PD-1) and its ligand (PD-L1) play key roles in cancer immune evasion and in modulating neuroinflammation. This systematic review and meta-analysis investigated the effect of PD-1/PD-L1 blockade on pathology and cognitive function in Alzheimer’s disease (AD) in preclinical and clinical studies. Relevant studies were systematically identified using the MEDLINE, Embase, CENTRAL, and Web of Science databases from their inception until April 10, 2024. In total, 33 studies were included in this meta-analysis, conducted using R software. Preclinical studies revealed that blockade of PD-1 signaling reduces amyloid-beta plaque burden, tau phosphorylation, and astrocyte reactivity in AD mouse models, accompanied by improvements in cognitive function in behavioral tests. Furthermore, clinical studies demonstrated the beneficial effect of PD-1 signaling inhibitors on cognitive function in cancer patients. This study highlights the necessity for additional research to clarify the exact mechanisms by which PD-1/PD-L1 inhibition impacts AD pathology and cognitive function, opening avenues for potential therapeutic strategies targeting this pathway in AD.