The CEACAM1/TIM-3 interaction represents a complex checkpoint axis distinct from PD-1/PD-L1. Both molecules are upregulated on exhausted T cells and can:
- Cis interaction: CEACAM1 and TIM-3 on the same T cell stabilize each other, promoting inhibitory signaling
- Trans interaction: CEACAM1 on tumor or myeloid cells engages TIM-3 on T cells
This dual interaction mode creates a checkpoint system that can signal even without opposing cell contact.