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黑色素瘤中的细胞衰老与免疫衰老:来自肿瘤微环境的见解

Cellular Senescence and Immunosenescence in Melanoma: Insights From the Tumor Microenvironment.

作者信息

Xiong Lihua, Cheng Jian

机构信息

Department of Dermatology, Cheng Du Xinjin District Hospital of Traditional Chinese Medicine, Chengdu, China.

Department of Chinese Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Cancer Med. 2025 Sep;14(17):e71223. doi: 10.1002/cam4.71223.

Abstract

BACKGROUND

Melanoma is one of the most immunogenic malignancies, yet resistance to immune checkpoint inhibitors (ICIs) remains a major obstacle to durable therapeutic success. Emerging evidence indicates that aging-related processes, including cellular senescence and immunosenescence, can reshape the tumor microenvironment (TME) to favor immune evasion and disease progression. Senescent melanoma and stromal cells secrete a senescence-associated secretory phenotype (SASP) that alters immune cell recruitment and function, while immunosenescence leads to diminished cytotoxic responses and the accumulation of dysfunctional or suppressive immune subsets.

AIM

This review explores the interplay between cellular senescence and immunosenescence in melanoma, highlighting their contributions to tumor progression and immunotherapy resistance, and discusses potential strategies to therapeutically target senescence-related pathways.

METHODS

A systematic review of studies published between 2000 and 2024 was performed using PubMed, Web of Science, and Scopus. Literature included mechanistic investigations of senescence in melanoma, analyses of immunosenescence in cancer patients, and preclinical or translational studies targeting senescence-related pathways.

RESULTS AND CONCLUSIONS

Senescent tumor and stromal cells drive a pro-inflammatory and immunosuppressive TME through SASP, while aging immune cells exhibit impaired antigen presentation, reduced cytotoxicity, and increased suppressive subsets. These dual processes form a self-reinforcing cycle of chronic inflammation and immune dysfunction, ultimately undermining the efficacy of ICIs. Targeting senescence, through senolytics, senostatics, or SASP modulators, has shown promise in preclinical models and may restore immune competence in melanoma. However, clinical translation requires further investigation to validate safety and efficacy. Addressing both cellular and immune senescence represents a novel and promising direction to overcome therapeutic resistance and improve melanoma outcomes.

摘要

背景

黑色素瘤是免疫原性最强的恶性肿瘤之一,但对免疫检查点抑制剂(ICI)的耐药性仍然是持久治疗成功的主要障碍。新出现的证据表明,与衰老相关的过程,包括细胞衰老和免疫衰老,可重塑肿瘤微环境(TME),从而有利于免疫逃逸和疾病进展。衰老的黑色素瘤细胞和基质细胞分泌衰老相关分泌表型(SASP),改变免疫细胞的募集和功能,而免疫衰老导致细胞毒性反应减弱以及功能失调或抑制性免疫亚群的积累。

目的

本综述探讨黑色素瘤中细胞衰老与免疫衰老之间的相互作用,强调它们对肿瘤进展和免疫治疗耐药性的影响,并讨论靶向衰老相关途径的潜在治疗策略。

方法

使用PubMed、Web of Science和Scopus对2000年至2024年间发表的研究进行系统综述。文献包括黑色素瘤衰老的机制研究、癌症患者免疫衰老的分析以及靶向衰老相关途径的临床前或转化研究。

结果与结论

衰老的肿瘤细胞和基质细胞通过SASP驱动促炎和免疫抑制性TME,而衰老的免疫细胞表现出抗原呈递受损、细胞毒性降低以及抑制性亚群增加。这些双重过程形成慢性炎症和免疫功能障碍的自我强化循环,最终削弱ICI的疗效。通过衰老细胞溶解剂、衰老稳定剂或SASP调节剂靶向衰老,在临床前模型中已显示出前景,并可能恢复黑色素瘤的免疫能力。然而,临床转化需要进一步研究以验证安全性和有效性。解决细胞衰老和免疫衰老问题代表了克服治疗耐药性和改善黑色素瘤治疗结果的一个新的且有前景的方向。

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