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肿瘤中的固有免疫:从机制到治疗

英文原题:Innate immunity in tumors: From mechanisms to therapeutics.

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Innate immunity in tumors: From mechanisms to therapeutics.

PubMed 2026/06/23(内容时间) Chin Med J (Engl) Q1 · IF 9.1(JCR 2025)

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中文摘要

癌症免疫治疗取得显著进展,但目前主要靶向适应性免疫系统的方法临床成功有限。先天免疫是第一道防线,可直接清除肿瘤细胞并激活适应性免疫应答。聚焦先天免疫的新兴疗法为应对这些挑战提供了有前景的方向。本综述探讨肿瘤微环境(TME)中主要先天免疫细胞的功能,包括自然杀伤(NK)细胞、树突状细胞(DC)、单核细胞、巨噬细胞、中性粒细胞、髓源性抑制细胞(MDSC)及T细胞;这些细胞既可发挥抗肿瘤作用,也具有促肿瘤的可塑性。

我们考察TME通过多种机制损害先天免疫的方式,包括免疫检查点失调、代谢重编程、抑制性细胞因子信号、细胞外囊泡、细胞外基质(ECM)改变及血管生成。为克服这些抑制作用,我们重点介绍新兴治疗策略,包括通过CAR-NK、CAR-巨噬细胞及CAR-T 等工程化细胞疗法增强肿瘤靶向和持久性,以及利用抗体、工程化细胞因子等大分子策略逆转免疫抑制、重编程TME。增强先天免疫是将“冷”肿瘤转变为免疫学“热”肿瘤的关键。未来进展依赖整合单细胞多组学以研究免疫异质性、优化工程化疗法,并开发同时利用先天和适应性免疫的联合治疗,从而实现更有效的癌症免疫治疗。

展开英文摘要原文

Cancer immunotherapy has made significant strides, yet current approaches mainly targeting the adaptive immune system yield limited clinical success. Innate immunity, as the first line of defense, directly eliminates tumor cells and activates adaptive responses. Emerging therapies focused on innate immunity offer a promising frontier to address these challenges.

This review explores the functions of major innate immune cells, including natural killer (NK) cells, dendritic cells (DCs), monocytes, macrophages, neutrophils, myeloid-derived suppressor cells (MDSCs), and T-cells within the tumor microenvironment (TME), where they demonstrate both antitumor activity and protumorigenic plasticity.

We examine how the TME impairs innate immunity through multiple mechanisms, including dysregulation of immune checkpoints, metabolic reprogramming, inhibitory cytokine signaling, extracellular vesicles, alterations in the extracellular matrix (ECM), and angiogenesis. To overcome these suppressive influences, we highlight emerging therapeutic strategies, including engineered cellular therapies such as chimeric antigen receptor (CAR)-NK cells, CAR-macrophages, and CAR- T-cells to enhance tumor targeting and persistence, and macromolecular strategies (e.

g. , antibodies, engineered cytokines) to reverse immunosuppression and reprogram the TME. Enhancing innate immunity is key to transforming "cold" tumors into immunologically "hot" ones. Future progress will rely on integrating single-cell multiomics to explore immune heterogeneity, optimizing engineered therapies, and developing combination treatments that leverage both innate and adaptive immunity for more effective cancer immunotherapy.

论文信息

作者
Hu Y、Wang X、Ma H、Zheng X
第一作者单位
State Key Laboratory of Immune Response and Immunotherapy, Institute of Immunology, School of Basic Medical Sciences, Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230027, China.China
期刊
Chinese medical journal2026 Jun 23
原文标识
PubMed 42337247 · DOI 10.1097/CM9.0000000000004116