Chen Shuangyu, Chen Wenqian, Xu Tinghui, Li Jiayang, Yu Jianghao, He Yibo, Qiu Shengliang
The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Front Immunol. 2025 Aug 18;16:1639823. doi: 10.3389/fimmu.2025.1639823. eCollection 2025.
Gastric cancer (GC) remains one of the leading causes of cancer-related mortality worldwide, with limited responses to immune checkpoint blockade (ICB) therapies in most patients. Increasing evidence indicates that the tumor immune microenvironment (TIME) plays a crucial role in immunotherapy outcomes. Among various metabolic abnormalities in the TIME, dysregulated lipid metabolism has emerged as a critical determinant of immune cell fate, differentiation, and function. In this review, we comprehensively summarize the current understanding of the immune landscape in GC, focusing on how altered lipid metabolism reshapes immune cell populations-including tumor-associated macrophages (TAMs), dendritic cells (DCs), regulatory T cells (Tregs), myeloid-derived suppressor cells (MDSCs), and cytotoxic CD8 T cells. We highlight key metabolic pathways such as fatty acid oxidation(FAO), cholesterol homeostasis, and lipid uptake that impact immune cell activity, contributing to immune evasion and therapeutic resistance. Importantly, we explore emerging therapeutic strategies targeting lipid metabolism, including inhibitors of cluster of differentiation 36 (CD36), fatty acid synthase (FASN), and sterol regulatory element-binding protein 1 (SREBP1) and discuss their synergistic potential when combined with ICB therapies. In conclusion, lipid metabolic reprogramming represents a promising yet underexplored axis in modulating antitumor immunity in GC. Integrating metabolic intervention with immunotherapy holds potential to overcome current treatment limitations and improve clinical outcomes. Future studies incorporating spatial omics and single-cell profiling will be essential to elucidate cell-type specific metabolic dependencies and foster translational breakthroughs.
胃癌(GC)仍然是全球癌症相关死亡的主要原因之一,大多数患者对免疫检查点阻断(ICB)疗法反应有限。越来越多的证据表明,肿瘤免疫微环境(TIME)在免疫治疗结果中起着关键作用。在TIME的各种代谢异常中,脂质代谢失调已成为免疫细胞命运、分化和功能的关键决定因素。在这篇综述中,我们全面总结了目前对GC免疫格局的理解,重点关注脂质代谢改变如何重塑免疫细胞群体,包括肿瘤相关巨噬细胞(TAM)、树突状细胞(DC)、调节性T细胞(Treg)、髓源性抑制细胞(MDSC)和细胞毒性CD8 T细胞。我们强调了影响免疫细胞活性的关键代谢途径,如脂肪酸氧化(FAO)、胆固醇稳态和脂质摄取,这些途径导致免疫逃逸和治疗抵抗。重要的是,我们探索了针对脂质代谢的新兴治疗策略,包括分化簇36(CD36)、脂肪酸合酶(FASN)和固醇调节元件结合蛋白1(SREBP1)的抑制剂,并讨论了它们与ICB疗法联合时的协同潜力。总之,脂质代谢重编程是调节GC抗肿瘤免疫中一个有前景但尚未充分探索的轴。将代谢干预与免疫疗法相结合有可能克服当前的治疗局限性并改善临床结果。纳入空间组学和单细胞分析的未来研究对于阐明细胞类型特异性代谢依赖性和促进转化突破至关重要。
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