Journal of Vaccine Research 2024, Vol.14, No.3, 147-156 http://medscipublisher.com/index.php/jvr 148 Additionally, mRNA vaccines do not carry the risk of genomic integration, a potential issue with DNA-based vaccines, and have been shown to induce strong immune responses without the need for additional adjuvants (Pardi et al., 2020). This has made mRNA vaccines a revolutionary strategy in preventing and treating numerous diseases, including cancers (Tan et al., 2023). This study aims to provide a comprehensive overview of the current state of research and development of mRNA vaccines in the treatment of breast cancer. It explores the mechanisms by which mRNA vaccines induce anti-tumor responses, reviews the latest advancements and trends in the field, and discusses the efficacy and safety of these vaccines based on recent clinical trials. The study also addresses the challenges and limitations associated with mRNA vaccine development and highlights future directions and innovations that could enhance their therapeutic potential. By synthesizing the latest research, the study illustrates the role of mRNA vaccines in potentially revolutionizing breast cancer treatment and improving patient outcomes. 2 Mechanisms of mRNA Vaccines in Cancer Immunotherapy 2.1 Basic principles of mRNA vaccines mRNA vaccines operate on a straightforward yet highly effective principle: they deliver synthetic messenger RNA (mRNA) into cells to produce an antigen, which in turn elicits an immune response. This mRNA encodes for a tumor-associated antigen (TAA) specific to breast cancer cells. Once inside the body, the mRNA is taken up by antigen-presenting cells (APCs), such as dendritic cells. These cells then translate the mRNA into the encoded protein antigen. This antigen is presented on the cell surface, where it is recognized by the immune system, particularly by T cells, which are critical in identifying and destroying cancer cells (Miao et al., 2021). The rapid production and customization capabilities of mRNA vaccines make them particularly suitable for targeting the diverse and evolving nature of tumor cells (Liu et al., 2023). 2.2 Immune response activation The activation of an immune response by mRNA vaccines involves both innate and adaptive immunity (Figure 1). Upon injection, mRNA vaccines are taken up by APCs, which recognize the mRNA as foreign due to its structural properties, leading to the activation of innate immune pathways. This activation involves pattern recognition receptors such as Toll-like receptors (TLRs), which detect the mRNA and initiate an immune response by producing cytokines and chemokines. These signaling molecules help recruit and activate various immune cells (Tan et al., 2023). Figure 1 Process of In Vitro Transcription of mRNA and Innate Immune Activation (Adapted from Xu et al., 2020) Image caption: A describes the in vitro transcription of mRNA using a DNA template containing an antigen-coding sequence, producing single-stranded RNA (ssRNA) and double-stranded RNA (dsRNA) products; B illustrates how mRNA enters the host cell cytoplasm through endocytosis. Some of the mRNA binds to host cell ribosomes and is successfully translated, producing antigen proteins. These proteins can be degraded into antigen peptides by proteasomes in the cytoplasm and presented to cytotoxic T lymphocytes (CTLs) via the major histocompatibility complex (MHC) class I pathway; C explains the self-adjuvant effect of mRNA. The figure shows how various pattern recognition receptors (PRRs) can recognize mRNA in vitro transcription products, triggering the activation of antigen-presenting cells (APCs) and inflammatory responses (Adapted from Xu et al., 2020)
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