Treg细胞:肝细胞癌发生发展的重要因素
Regulatory T Cells: A Critical Factor in the Development and Progression of Hepatocellular Carcinoma
DOI: 10.12677/acm.2026.1662315, PDF,   
作者: 陈清纯, 郑伟穰, 谭丽明, 王译旋, 华胜妮*:暨南大学珠海临床医学院(珠海市人民医院,北京理工大学附属医院),广东 珠海
关键词: Treg细胞肝细胞癌肿瘤微环境Regulatory T Cells (Tregs) Hepatocellular Carcinoma (HCC) Tumor Microenvironment (TME)
摘要: 肝癌不仅是全球范围内,也是我国高发恶性肿瘤之一,2022年,肝癌的发病率位居全国癌症发病率的第三名,病死率位居全国第二。调节性T细胞(Treg)是CD4+T细胞亚群,约占外周血CD4+T细胞的5%。Foxp3是Treg的特征性表达转录因子,可维持Treg细胞的免疫稳态。在肝癌中,Treg (主要为CD4+CD25+Foxp3+亚型)通过接触依赖型检查点通路(Treg表面分子与其他细胞结合)和可溶性抑制性细胞因子通路(分泌抑制性细胞因子)协同抑制抗肿瘤免疫反应,介导肿瘤免疫逃逸。同时,肝癌微环境可通过多种途径重编程Treg,促使Treg分化为不同功能亚型。在临床应用上,Treg可用于HCC的鉴别诊断、治疗、预后判断等。
Abstract: Hepatocellular carcinoma (HCC) is not only one of the malignancies with high incidence globally, but also ranks among the common high-incidence malignant tumors in China. In 2022, HCC ranked third in incidence and second in mortality among all cancers nationwide. Regulatory T cells (Tregs), a subset of CD4+T cells, constitute approximately 5% of peripheral CD4+T cells. Foxp3 serves as the lineage-specific transcription factor for Tregs, essential for maintaining their immune homeostasis. In the context of HCC, Tregs—primarily the CD4+CD25+Foxp3+ subset—synergistically suppress anti-tumor immune responses and mediate immune escape via contact-dependent checkpoint pathways (involving surface molecule interactions) and soluble inhibitory cytokine pathways. Concurrently, the HCC microenvironment reprograms Tregs through multiple mechanisms, driving their differentiation into distinct functional subtypes. Clinically, Tregs hold significant potential as biomarkers for the differential diagnosis, prognostic stratification, and therapeutic targeting of HCC.
文章引用:陈清纯, 郑伟穰, 谭丽明, 王译旋, 华胜妮. Treg细胞:肝细胞癌发生发展的重要因素[J]. 临床医学进展, 2026, 16(6): 1088-1103. https://doi.org/10.12677/acm.2026.1662315

参考文献

[1] Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R.L., Soerjomataram, I., et al. (2024) Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 74, 229-263. [Google Scholar] [CrossRef] [PubMed]
[2] Han, B., Zheng, R., Zeng, H., Wang, S., Sun, K., Chen, R., et al. (2024) Cancer Incidence and Mortality in China, 2022. Journal of the National Cancer Center, 4, 47-53. [Google Scholar] [CrossRef] [PubMed]
[3] Llovet, J.M., Kelley, R.K., Villanueva, A., Singal, A.G., Pikarsky, E., Roayaie, S., et al. (2021) Hepatocellular Carcinoma. Nature Reviews Disease Primers, 7, Article No. 6. [Google Scholar] [CrossRef] [PubMed]
[4] Global Burden of Disease Liver Cancer Collaboration, Akinyemiju, T., Abera, S., et al. (2017) The Burden of Primary Liver Cancer and Underlying Etiologies from 1990 to 2015 at the Global, Regional, and National Level: Results from the Global Burden of Disease Study 2015. JAMA Oncology, 3, 1683-1691.
[5] Sartoris, R., Gregory, J., Dioguardi Burgio, M., Ronot, M. and Vilgrain, V. (2021) HCC Advances in Diagnosis and Prognosis: Digital and Imaging. Liver International, 41, 73-77. [Google Scholar] [CrossRef] [PubMed]
[6] Reig, M., Forner, A., Rimola, J., Ferrer-Fàbrega, J., Burrel, M., Garcia-Criado, Á., et al. (2022) BCLC Strategy for Prognosis Prediction and Treatment Recommendation: The 2022 Update. Journal of Hepatology, 76, 681-693. [Google Scholar] [CrossRef] [PubMed]
[7] Frydrychowicz, M., Boruczkowski, M., Kolecka-Bednarczyk, A. and Dworacki, G. (2017) The Dual Role of Treg in Cancer. Scandinavian Journal of Immunology, 86, 436-443. [Google Scholar] [CrossRef] [PubMed]
[8] Khan, U. and Ghazanfar, H. (2018) T Lymphocytes and Autoimmunity. International Review of Cell and Molecular Biology, 341, 125-168.
[9] Grover, P., Goel, P.N. and Greene, M.I. (2021) Regulatory T Cells: Regulation of Identity and Function. Frontiers in Immunology, 12, Article 750542. [Google Scholar] [CrossRef] [PubMed]
[10] Attias, M., Al-Aubodah, T. and Piccirillo, C.A. (2019) Mechanisms of Human FoxP3+ Treg Cell Development and Function in Health and Disease. Clinical and Experimental Immunology, 197, 36-51. [Google Scholar] [CrossRef] [PubMed]
[11] Jiang, Q., Yang, G., Liu, Q., Wang, S. and Cui, D. (2021) Function and Role of Regulatory T Cells in Rheumatoid Arthritis. Frontiers in Immunology, 12, Article 626193. [Google Scholar] [CrossRef] [PubMed]
[12] Ajith, A., Merimi, M., Arki, M.K., Hossein-Khannazer, N., Najar, M., Vosough, M., et al. (2024) Immune Regulation and Therapeutic Application of T Regulatory Cells in Liver Diseases. Frontiers in Immunology, 15, Article 1371089. [Google Scholar] [CrossRef] [PubMed]
[13] Deng, Z., Fan, T., Xiao, C., Tian, H., Zheng, Y., Li, C., et al. (2024) TGF-β Signaling in Health, Disease and Therapeutics. Signal Transduction and Targeted Therapy, 9, Article No. 61. [Google Scholar] [CrossRef] [PubMed]
[14] Thomas, D.A. and Massagué, J. (2005) TGF-β Directly Targets Cytotoxic T Cell Functions during Tumor Evasion of Immune Surveillance. Cancer Cell, 8, 369-380. [Google Scholar] [CrossRef] [PubMed]
[15] Fujii, R., Jochems, C., Tritsch, S.R., Wong, H.C., Schlom, J. and Hodge, J.W. (2018) An IL-15 Superagonist/IL-15Rα Fusion Complex Protects and Rescues NK Cell-Cytotoxic Function from TGF-β1-Mediated Immunosuppression. Cancer Immunology, Immunotherapy, 67, 675-689. [Google Scholar] [CrossRef] [PubMed]
[16] Tauriello, D.V.F., Sancho, E. and Batlle, E. (2022) Overcoming TGFβ-Mediated Immune Evasion in Cancer. Nature Reviews Cancer, 22, 25-44. [Google Scholar] [CrossRef] [PubMed]
[17] Rubtsov, Y.P., Rasmussen, J.P., Chi, E.Y., Fontenot, J., Castelli, L., Ye, X., et al. (2008) Regulatory T Cell-Derived Interleukin-10 Limits Inflammation at Environmental Interfaces. Immunity, 28, 546-558. [Google Scholar] [CrossRef] [PubMed]
[18] Gondek, D.C., Lu, L., Quezada, S.A., Sakaguchi, S. and Noelle, R.J. (2005) Cutting Edge: Contact-Mediated Suppression by CD4+CD25+ Regulatory Cells Involves a Granzyme B-Dependent, Perforin-Independent Mechanism. The Journal of Immunology, 174, 1783-1786. [Google Scholar] [CrossRef] [PubMed]
[19] Osińska, I., Popko, K. and Demkow, U. (2014) Perforin: An Important Player in Immune Response. Central European Journal of Immunology, 39, 109-115. [Google Scholar] [CrossRef] [PubMed]
[20] Veugelers, K., Motyka, B., Goping, I.S., Shostak, I., Sawchuk, T. and Bleackley, R.C. (2006) Granule-Mediated Killing by Granzyme B and Perforin Requires a Mannose 6-Phosphate Receptor and Is Augmented by Cell Surface Heparan Sulfate. Molecular Biology of the Cell, 17, 623-633. [Google Scholar] [CrossRef] [PubMed]
[21] Tung, S.L., Fanelli, G., Matthews, R.I., Bazoer, J., Letizia, M., Vizcay-Barrena, G., et al. (2020) Regulatory T Cell Extracellular Vesicles Modify T-Effector Cell Cytokine Production and Protect against Human Skin Allograft Damage. Frontiers in Cell and Developmental Biology, 8, Article 317. [Google Scholar] [CrossRef] [PubMed]
[22] Rojas, C., Campos-Mora, M., Cárcamo, I., Villalón, N., Elhusseiny, A., Contreras-Kallens, P., et al. (2020) T Regulatory Cells-Derived Extracellular Vesicles and Their Contribution to the Generation of Immune Tolerance. Journal of Leukocyte Biology, 108, 813-824. [Google Scholar] [CrossRef] [PubMed]
[23] Qureshi, O.S., Zheng, Y., Nakamura, K., Attridge, K., Manzotti, C., Schmidt, E.M., et al. (2011) Trans-Endocytosis of CD80 and CD86: A Molecular Basis for the Cell-Extrinsic Function of CTLA-4. Science, 332, 600-603. [Google Scholar] [CrossRef] [PubMed]
[24] Yan, Y., Zhang, G.X., Gran, B., Fallarino, F., Yu, S., Li, H., et al. (2010) IDO Upregulates Regulatory T Cells via Tryptophan Catabolite and Suppresses Encephalitogenic T Cell Responses in Experimental Autoimmune Encephalomyelitis. The Journal of Immunology, 185, 5953-5961. [Google Scholar] [CrossRef] [PubMed]
[25] Togashi, Y., Shitara, K. and Nishikawa, H. (2019) Regulatory T Cells in Cancer Immunosuppression—Implications for Anticancer Therapy. Nature Reviews Clinical Oncology, 16, 356-371. [Google Scholar] [CrossRef] [PubMed]
[26] Spolski, R., Li, P. and Leonard, W.J. (2018) Biology and Regulation of IL-2: From Molecular Mechanisms to Human Therapy. Nature Reviews Immunology, 18, 648-659. [Google Scholar] [CrossRef] [PubMed]
[27] Langhans, B., Nischalke, H.D., Krämer, B., Dold, L., Lutz, P., Mohr, R., et al. (2019) Role of Regulatory T Cells and Checkpoint Inhibition in Hepatocellular Carcinoma. Cancer Immunology, Immunotherapy, 68, 2055-2066. [Google Scholar] [CrossRef] [PubMed]
[28] Zhang, C.Y., Liu, S. and Yang, M. (2022) Regulatory T Cells and Their Associated Factors in Hepatocellular Carcinoma Development and Therapy. World Journal of Gastroenterology, 28, 3346-3358. [Google Scholar] [CrossRef] [PubMed]
[29] Fortunato, M., Amodio, G. and Gregori, S. (2023) IL-10-Engineered Dendritic Cells Modulate Allogeneic CD8+ T Cell Responses. International Journal of Molecular Sciences, 24, Article 9128. [Google Scholar] [CrossRef] [PubMed]
[30] Wang, X., Li, J., Lu, C., Wang, G., Wang, Z., Liu, X., et al. (2019) IL-10-Producing B Cells in Differentiated Thyroid Cancer Suppress the Effector Function of T Cells but Improve Their Survival Upon Activation. Experimental Cell Research, 376, 192-197. [Google Scholar] [CrossRef] [PubMed]
[31] Bejarano, M.T., de Waal Malefyt, R., Abrams, J.S., et al. (1992) Interleukin 10 Inhibits Allogeneic Proliferative and Cytotoxic T Cell Responses Generated in Primary Mixed Lymphocyte Cultures. International Immunology, 4, 1389-1397. [Google Scholar] [CrossRef] [PubMed]
[32] Steinbrink, K., Jonuleit, H., Müller, G., Schuler, G., Knop, J. and Enk, A.H. (1999) Interleukin-10-Treated Human Dendritic Cells Induce a Melanoma-Antigen-Specific Anergy in CD8+ T Cells Resulting in a Failure to Lyse Tumor Cells. Blood, 93, 1634-1642. [Google Scholar] [CrossRef
[33] Collison, L.W., Delgoffe, G.M., Guy, C.S., Vignali, K.M., Chaturvedi, V., Fairweather, D., et al. (2012) The Composition and Signaling of the IL-35 Receptor Are Unconventional. Nature Immunology, 13, 290-299. [Google Scholar] [CrossRef] [PubMed]
[34] Picant, V., Revol-Bauz, L., Tonon, L., Casini, T., Voissière, A., Poujol, D., et al. (2025) Interleukin-35 Impairs Human NK Cell Effector Functions and Induces Their ILC1-Like Conversion with Tissue Residency Features. Nature Communications, 16, Article No. 6135. [Google Scholar] [CrossRef] [PubMed]
[35] Liu, X., Ren, H., Guo, H., Wang, W. and Zhao, N. (2021) Interleukin-35 Has a Tumor-Promoting Role in Hepatocellular Carcinoma. Clinical and Experimental Immunology, 203, 219-229. [Google Scholar] [CrossRef] [PubMed]
[36] Dasgupta, S., Bhattacharya-Chatterjee, M., O’Malley, B.W. and Chatterjee, S.K. (2005) Inhibition of NK Cell Activity through TGF-β1 by Down-Regulation of NKG2D in a Murine Model of Head and Neck Cancer. The Journal of Immunology, 175, 5541-5550. [Google Scholar] [CrossRef] [PubMed]
[37] Lee, J.C., Lee, K.M., Kim, D.W., et al. (2004) Elevated TGF-β1 Secretion and Down-Modulation of NKG2D Underlies Impaired NK Cytotoxicity in Cancer Patients. The Journal of Immunology, 172, 7335-7340. [Google Scholar] [CrossRef] [PubMed]
[38] Lazarova, M. and Steinle, A. (2019) Impairment of NKG2D-Mediated Tumor Immunity by TGF-β. Frontiers in Immunology, 10, Article 2689. [Google Scholar] [CrossRef] [PubMed]
[39] Zhang, C., Gao, Y., Du, C., Markowitz, G.J., Fu, J., Zhang, Z., et al. (2021) Hepatitis B-Induced IL8 Promotes Hepatocellular Carcinoma Venous Metastasis and Intrahepatic Treg Accumulation. Cancer Research, 81, 2386-2398. [Google Scholar] [CrossRef] [PubMed]
[40] Battaglia, S., Benzoubir, N., Nobilet, S., Charneau, P., Samuel, D., Zignego, A.L., et al. (2009) Liver Cancer-Derived Hepatitis C Virus Core Proteins Shift TGF-Beta Responses from Tumor Suppression to Epithelial-Mesenchymal Transition. PLOS ONE, 4, e4355. [Google Scholar] [CrossRef] [PubMed]
[41] Cairoli, V., De Matteo, E., Rios, D., Lezama, C., Galoppo, M., Casciato, P., et al. (2021) Hepatic Lymphocytes Involved in the Pathogenesis of Pediatric and Adult Non-Alcoholic Fatty Liver Disease. Scientific Reports, 11, Article No. 5129. [Google Scholar] [CrossRef] [PubMed]
[42] Harley, I.T.W., Stankiewicz, T.E., Giles, D.A., Softic, S., Flick, L.M., Cappelletti, M., et al. (2014) IL-17 Signaling Accelerates the Progression of Nonalcoholic Fatty Liver Disease in Mice. Hepatology, 59, 1830-1839. [Google Scholar] [CrossRef] [PubMed]
[43] Duan, Y., Luo, J., Pan, X., Wei, J., Xiao, X., Li, J., et al. (2022) Association between Inflammatory Markers and Non-Alcoholic Fatty Liver Disease in Obese Children. Frontiers in Public Health, 10, Article 991393. [Google Scholar] [CrossRef] [PubMed]
[44] Velliou, R., Mitroulis, I. and Chatzigeorgiou, A. (2022) Neutrophil Extracellular Traps Contribute to the Development of Hepatocellular Carcinoma in NASH by Promoting Treg Differentiation. Hepatobiliary Surgery and Nutrition, 11, 415-418. [Google Scholar] [CrossRef] [PubMed]
[45] Chaudhary, S., Rai, R., Pal, P.B., et al. (2023) Western Diet Dampens T Regulatory Cell Function to Fuel Hepatic Inflammation in Nonalcoholic Fatty Liver Disease.
[46] Sun, Y., Wu, L., Zhong, Y., Zhou, K., Hou, Y., Wang, Z., et al. (2021) Single-Cell Landscape of the Ecosystem in Early-Relapse Hepatocellular Carcinoma. Cell, 184, 404-421.e16. [Google Scholar] [CrossRef] [PubMed]
[47] Wu, X., Zhou, Z., Cao, Q., Chen, Y., Gong, J., Zhang, Q., et al. (2023) Reprogramming of Treg Cells in the Inflammatory Microenvironment during Immunotherapy: A Literature Review. Frontiers in Immunology, 14, Article 1268188. [Google Scholar] [CrossRef] [PubMed]
[48] Sakowska, J., Arcimowicz, Ł., Jankowiak, M., Papak, I., Markiewicz, A., Dziubek, K., et al. (2022) Autoimmunity and Cancer—Two Sides of the Same Coin. Frontiers in Immunology, 13, Article 793234. [Google Scholar] [CrossRef] [PubMed]
[49] Liu, J., Zhang, B., Zhang, G. and Shang, D. (2024) Reprogramming of Regulatory T Cells in Inflammatory Tumor Microenvironment: Can It Become Immunotherapy Turning Point? Frontiers in Immunology, 15, Article 1345838. [Google Scholar] [CrossRef] [PubMed]
[50] Yan, Y., Huang, L., Liu, Y., Yi, M., Chu, Q., Jiao, D., et al. (2022) Metabolic Profiles of Regulatory T Cells and Their Adaptations to the Tumor Microenvironment: Implications for Antitumor Immunity. Journal of Hematology & Oncology, 15, Article No. 104. [Google Scholar] [CrossRef] [PubMed]
[51] Miao, Y., Zhang, C., Yang, L., Zeng, X., Hu, Y., Xue, X., et al. (2022) The Activation of PPARγ Enhances Treg Responses through Up-Regulating CD36/CPT1-Mediated Fatty Acid Oxidation and Subsequent N-Glycan Branching of TβRII/IL-2Rα. Cell Communication and Signaling, 20, Article No. 48. [Google Scholar] [CrossRef] [PubMed]
[52] Rekhi, U.R., Catunda, R.Q., Alexiou, M., Sharma, M., Fong, A. and Febbraio, M. (2021) Impact of a CD36 Inhibitor on Porphyromonas Gingivalis Mediated Atherosclerosis. Archives of Oral Biology, 126, Article 105129. [Google Scholar] [CrossRef] [PubMed]
[53] Duarte, J.A., de Barros, A.L.B. and Leite, E.A. (2021) The Potential Use of Simvastatin for Cancer Treatment: A Review. Biomedicine & Pharmacotherapy, 141, Article 111858. [Google Scholar] [CrossRef] [PubMed]
[54] Yang, K., Blanco, D.B., Neale, G., Vogel, P., Avila, J., Clish, C.B., et al. (2017) Homeostatic Control of Metabolic and Functional Fitness of Treg Cells by LKB1 Signalling. Nature, 548, 602-606. [Google Scholar] [CrossRef] [PubMed]
[55] He, N., Fan, W., Henriquez, B., Yu, R.T., Atkins, A.R., Liddle, C., et al. (2017) Metabolic Control of Regulatory T Cell (Treg) Survival and Function by Lkb1. Proceedings of the National Academy of Sciences, 114, 12542-12547. [Google Scholar] [CrossRef] [PubMed]
[56] Wang, J., Zhao, X. and Wan, Y.Y. (2023) Intricacies of TGF-β Signaling in Treg and Th17 Cell Biology. Cellular & Molecular Immunology, 20, 1002-1022. [Google Scholar] [CrossRef] [PubMed]
[57] Xin, X., Cheng, X., Zeng, F., Xu, Q. and Hou, L. (2024) The Role of TGF-β/SMAD Signaling in Hepatocellular Carcinoma: From Mechanism to Therapy and Prognosis. International Journal of Biological Sciences, 20, 1436-1451. [Google Scholar] [CrossRef] [PubMed]
[58] Chen, J., Feng, W., Sun, M., Huang, W., Wang, G., Chen, X., et al. (2024) TGF-β1-Induced SOX18 Elevation Promotes Hepatocellular Carcinoma Progression and Metastasis through Transcriptionally Upregulating PD-L1 and Cxcl12. Gastroenterology, 167, 264-280. [Google Scholar] [CrossRef] [PubMed]
[59] Chen, J., Gingold, J.A. and Su, X. (2019) Immunomodulatory TGF-β Signaling in Hepatocellular Carcinoma. Trends in Molecular Medicine, 25, 1010-1023. [Google Scholar] [CrossRef] [PubMed]
[60] Dituri, F., Mancarella, S., Serino, G., Chaoul, N., Lupo, L.G., Villa, E., et al. (2021) Direct and Indirect Effect of TGFβ on Treg Transendothelial Recruitment in HCC Tissue Microenvironment. International Journal of Molecular Sciences, 22, Article 11765. [Google Scholar] [CrossRef] [PubMed]
[61] Jeffery, H.C., Jeffery, L.E., Lutz, P., Corrigan, M., Webb, G.J., Hirschfield, G.M., et al. (2017) Low-Dose Interleukin-2 Promotes STAT-5 Phosphorylation, Treg Survival and CTLA-4-Dependent Function in Autoimmune Liver Diseases. Clinical and Experimental Immunology, 188, 394-411. [Google Scholar] [CrossRef] [PubMed]
[62] Harris, F., Berdugo, Y.A. and Tree, T. (2022) IL-2-Based Approaches to Treg Enhancement. Clinical and Experimental Immunology, 211, 149-163. [Google Scholar] [CrossRef] [PubMed]
[63] Xie, K., Xu, L., Wu, H., Liao, H., Luo, L., Liao, M., et al. (2018) OX40 Expression in Hepatocellular Carcinoma Is Associated with a Distinct Immune Microenvironment, Specific Mutation Signature, and Poor Prognosis. OncoImmunology, 7, e1404214. [Google Scholar] [CrossRef] [PubMed]
[64] So, T., Lee, S.W. and Croft, M. (2008) Immune Regulation and Control of Regulatory T Cells by OX40 and 4-1BB. Cytokine & Growth Factor Reviews, 19, 253-262. [Google Scholar] [CrossRef] [PubMed]
[65] Vu, M.D., Xiao, X., Gao, W., Degauque, N., Chen, M., Kroemer, A., et al. (2007) OX40 Costimulation Turns off FOXP3+ Tregs. Blood, 110, 2501-2510. [Google Scholar] [CrossRef] [PubMed]
[66] Kagoya, Y., Saijo, H., Matsunaga, Y., Guo, T., Saso, K., Anczurowski, M., et al. (2019) Arginine Methylation of FOXP3 Is Crucial for the Suppressive Function of Regulatory T Cells. Journal of Autoimmunity, 97, 10-21. [Google Scholar] [CrossRef] [PubMed]
[67] Deng, G., Song, X., Fujimoto, S., Piccirillo, C.A., Nagai, Y. and Greene, M.I. (2019) Foxp3 Post-Translational Modifications and Treg Suppressive Activity. Frontiers in Immunology, 10, Article 2486. [Google Scholar] [CrossRef] [PubMed]
[68] Wang, A., Wang, Y., Liang, R., Li, B. and Pan, F. (2025) Improving Regulatory T Cell-Based Therapy: Insights into Post-Translational Modification Regulation. Journal of Genetics and Genomics, 52, 145-156. [Google Scholar] [CrossRef] [PubMed]
[69] Li, B., Samanta, A., Song, X., Iacono, K.T., Bembas, K., Tao, R., et al. (2007) FOXP3 Interactions with Histone Acetyltransferase and Class II Histone Deacetylases Are Required for Repression. Proceedings of the National Academy of Sciences, 104, 4571-4576. [Google Scholar] [CrossRef] [PubMed]
[70] Liu, Y., Wang, L., Predina, J., Han, R., Beier, U.H., Wang, L.S., et al. (2013) Inhibition of P300 Impairs FOXP3+ T Regulatory Cell Function and Promotes Antitumor Immunity. Nature Medicine, 19, 1173-1177. [Google Scholar] [CrossRef] [PubMed]
[71] Du, T., Nagai, Y., Xiao, Y., Greene, M.I. and Zhang, H. (2013) Lysosome-Dependent P300/FOXP3 Degradation and Limits Treg Cell Functions and Enhances Targeted Therapy against Cancers. Experimental and Molecular Pathology, 95, 38-45. [Google Scholar] [CrossRef] [PubMed]
[72] Xiao, H., Chung, J., Kao, H. and Yang, Y. (2003) Tip60 Is a Co-Repressor for STAT3. Journal of Biological Chemistry, 278, 11197-11204. [Google Scholar] [CrossRef] [PubMed]
[73] Hsu, L.H., Li, K.P., Chu, K.H., et al. (2015) A B-1a Cell Subset Induces Foxp3-T Cells with Regulatory Activity through an Il-10-Independent Pathway. Cellular & Molecular Immunology, 12, 354-365. [Google Scholar] [CrossRef] [PubMed]
[74] Murter, B. and Kane, L.P. (2020) Control of T Lymphocyte Fate Decisions by PI3K Signaling. F1000Research, 9, Article 1171. [Google Scholar] [CrossRef] [PubMed]
[75] Chien, C.H. and Chiang, B.L. (2018) Recent Advances in Regulatory T Cells Induced by B Cells. Cellular & Molecular Immunology, 15, 539-541. [Google Scholar] [CrossRef] [PubMed]
[76] Chen, X. and Jensen, P.E. (2007) Cutting Edge: Primary B Lymphocytes Preferentially Expand Allogeneic FoxP3+ CD4 T Cells. The Journal of Immunology, 179, 2046-2050. [Google Scholar] [CrossRef] [PubMed]
[77] Kapp, J.A., Honjo, K., Kapp, L.M., Goldsmith, K. and Bucy, R.P. (2007) Antigen, in the Presence of TGF-β, Induces Up-Regulation of FOXP3 GFP + in CD4+ TCR Transgenic T Cells That Mediate Linked Suppression of CD8+ T Cell Responses. The Journal of Immunology, 179, 2105-2114. [Google Scholar] [CrossRef] [PubMed]
[78] Mantovani, A. (1999) The Chemokine System: Redundancy for Robust Outputs. Immunology Today, 20, 254-257. [Google Scholar] [CrossRef] [PubMed]
[79] Balkwill, F. and Mantovani, A. (2001) Inflammation and Cancer: Back to Virchow? The Lancet, 357, 539-545. [Google Scholar] [CrossRef] [PubMed]
[80] Xie, Y., Liu, F., Wu, Y., Zhu, Y., Jiang, Y., Wu, Q., et al. (2025) Inflammation in Cancer: Therapeutic Opportunities from New Insights. Molecular Cancer, 24, Article No. 51. [Google Scholar] [CrossRef] [PubMed]
[81] Kambayashi, T., Alexander, H.R., Fong, M. and Strassmann, G. (1995) Potential Involvement of IL-10 in Suppressing Tumor-Associated Macrophages. Colon-26-Derived Prostaglandin E2 Inhibits TNF-Alpha Release via a Mechanism Involving Il-10. The Journal of Immunology, 154, 3383-3390. [Google Scholar] [CrossRef
[82] Mantovani, A., Sozzani, S., Locati, M., Allavena, P. and Sica, A. (2002) Macrophage Polarization: Tumor-Associated Macrophages as a Paradigm for Polarized M2 Mononuclear Phagocytes. Trends in Immunology, 23, 549-555. [Google Scholar] [CrossRef] [PubMed]
[83] Yang, X.H., Yamagiwa, S., Ichida, T., Matsuda, Y., Sugahara, S., Watanabe, H., et al. (2006) Increase of CD4+CD25+ Regulatory T-Cells in the Liver of Patients with Hepatocellular Carcinoma. Journal of Hepatology, 45, 254-262. [Google Scholar] [CrossRef] [PubMed]
[84] Sakaguchi, S., Mikami, N., Wing, J.B., Tanaka, A., Ichiyama, K. and Ohkura, N. (2020) Regulatory T Cells and Human Disease. Annual Review of Immunology, 38, 541-566. [Google Scholar] [CrossRef] [PubMed]
[85] Yang, C., Zhang, H., Zhang, L., Zhu, A.X., Bernards, R., Qin, W., et al. (2023) Evolving Therapeutic Landscape of Advanced Hepatocellular Carcinoma. Nature Reviews Gastroenterology & Hepatology, 20, 203-222. [Google Scholar] [CrossRef] [PubMed]
[86] Bollard, C.M., Tripic, T., Cruz, C.R., Dotti, G., Gottschalk, S., Torrano, V., et al. (2018) Tumor-Specific T-Cells Engineered to Overcome Tumor Immune Evasion Induce Clinical Responses in Patients with Relapsed Hodgkin Lymphoma. Journal of Clinical Oncology, 36, 1128-1139. [Google Scholar] [CrossRef] [PubMed]
[87] Brand, T., MacLellan, W.R. and Schneider, M.D. (1993) A Dominant-Negative Receptor for Type Beta Transforming Growth Factors Created by Deletion of the Kinase Domain. Journal of Biological Chemistry, 268, 11500-11503. [Google Scholar] [CrossRef] [PubMed]
[88] Luo, M., Zhang, H., Zhu, L., Xu, Q. and Gao, Q. (2021) CAR-T Cell Therapy: Challenges and Optimization. Critical Reviews in Immunology, 41, 77-87. [Google Scholar] [CrossRef] [PubMed]
[89] Suryadevara, C.M., Desai, R., Farber, S.H., Choi, B.D., Swartz, A.M., Shen, S.H., et al. (2019) Preventing LCK Activation in CAR T Cells Confers Treg Resistance but Requires 4-1BB Signaling for Them to Persist and Treat Solid Tumors in Nonlymphodepleted Hosts. Clinical Cancer Research, 25, 358-368. [Google Scholar] [CrossRef] [PubMed]
[90] Freeman, Z.T., Nirschl, T.R., Hovelson, D.H., Johnston, R.J., Engelhardt, J.J., Selby, M.J., et al. (2020) A Conserved Intratumoral Regulatory T Cell Signature Identifies 4-1BB as a Pan-Cancer Target. Journal of Clinical Investigation, 130, 1405-1416. [Google Scholar] [CrossRef] [PubMed]
[91] Zeng, K., Huang, M., Lyu, M., Khoury, J.D., Ahmed, S., Patel, K.K., et al. (2023) Adjunct Therapy with T Regulatory Cells Decreases Inflammation and Preserves the Anti-Tumor Activity of CAR T Cells. Cells, 12, Article 1880. [Google Scholar] [CrossRef] [PubMed]
[92] Long, X., Zhang, S., Wang, Y., Chen, J., Lu, Y., Hou, H., et al. (2024) Targeting JMJD1C to Selectively Disrupt Tumor Treg Cell Fitness Enhances Antitumor Immunity. Nature Immunology, 25, 525-536. [Google Scholar] [CrossRef] [PubMed]
[93] Hu, Y., Setayesh, T., Vaziri, F., Wu, X., Hwang, S.T., Chen, X., et al. (2023) miR-22 Gene Therapy Treats HCC by Promoting Anti-Tumor Immunity and Enhancing Metabolism. Molecular Therapy, 31, 1829-1845. [Google Scholar] [CrossRef] [PubMed]
[94] Badr, A.M., El-Ahwany, E., Goda, L., et al. (2021) MicroRNA-26a Systemic Administration Attenuates Tumor Formation in Hepatocellular Carcinoma Mouse Model. Pakistan Journal of Pharmaceutical Sciences, 34, 925-932.
[95] Chen, L., Zheng, J., Zhang, Y., Yang, L., Wang, J., Ni, J., et al. (2011) Tumor-Specific Expression of MicroRNA-26a Suppresses Human Hepatocellular Carcinoma Growth via Cyclin-Dependent and-Independent Pathways. Molecular Therapy, 19, 1521-1528. [Google Scholar] [CrossRef] [PubMed]
[96] Yang, X., Liang, L., Zhang, X.F., et al. (2013) MicroRNA-26a Suppresses Tumor Growth and Metastasis of Human Hepatocellular Carcinoma by Targeting Interleukin-6-Stat3 Pathway. Hepatology, 58, 158-170. [Google Scholar] [CrossRef] [PubMed]
[97] Yang, X., Zhang, X.F., Lu, X., et al. (2014) MicroRNA-26a Suppresses Angiogenesis in Human Hepatocellular Carcinoma by Targeting Hepatocyte Growth Factor-cMet Pathway. Hepatology, 59, 1874-1885. [Google Scholar] [CrossRef] [PubMed]
[98] Ma, Y., Deng, F., Li, P., Chen, G., Tao, Y. and Wang, H. (2018) The Tumor Suppressive miR-26a Regulation of FBXO11 Inhibits Proliferation, Migration and Invasion of Hepatocellular Carcinoma Cells. Biomedicine & Pharmacotherapy, 101, 648-655. [Google Scholar] [CrossRef] [PubMed]
[99] Zhang, H., Xia, P., Yang, Z., Liu, J., Zhu, Y., Huang, Z., et al. (2023) Cullin-Associated and Neddylation-Dissociated 1 Regulate Reprogramming of Lipid Metabolism through Skp1-cullin-1-F-boxFBXO11-Mediated Heterogeneous Nuclear Ribonucleoprotein A2/B1 Ubiquitination and Promote Hepatocellular Carcinoma. Clinical and Translational Medicine, 13, e1443. [Google Scholar] [CrossRef] [PubMed]
[100] Liu, J., Bai, Y., Liu, X., Zhou, B., Sun, P., Wang, Y., et al. (2024) Enhanced Efficacy of Combined VEGFR Peptide-Drug Conjugate and Anti-Pd-1 Antibody in Treating Hepatocellular Carcinoma. Scientific Reports, 14, Article No. 21728. [Google Scholar] [CrossRef] [PubMed]
[101] Voron, T., Marcheteau, E., Pernot, S., Colussi, O., Tartour, E., Taieb, J., et al. (2014) Control of the Immune Response by Pro-Angiogenic Factors. Frontiers in Oncology, 4, Article 70. [Google Scholar] [CrossRef] [PubMed]
[102] Bao, X., Shen, N., Lou, Y., Yu, H., Wang, Y., Liu, L., et al. (2021) Enhanced Anti-Pd-1 Therapy in Hepatocellular Carcinoma by Tumor Vascular Disruption and Normalization Dependent on Combretastatin A4 Nanoparticles and Dc101. Theranostics, 11, 5955-5969. [Google Scholar] [CrossRef] [PubMed]
[103] Yang, W., Feng, Y., Zhou, J., Cheung, O.K., Cao, J., Wang, J., et al. (2021) A Selective HDAC8 Inhibitor Potentiates Antitumor Immunity and Efficacy of Immune Checkpoint Blockade in Hepatocellular Carcinoma. Science Translational Medicine, 13, eaaz6804. [Google Scholar] [CrossRef] [PubMed]
[104] Zhou, Y., Wang, B., Wu, J., Zhang, C., Zhou, Y., Yang, X., et al. (2016) Association of Preoperative EpCAM Circulating Tumor Cells and Peripheral Treg Cell Levels with Early Recurrence of Hepatocellular Carcinoma Following Radical Hepatic Resection. BMC Cancer, 16, Article No. 506. [Google Scholar] [CrossRef] [PubMed]
[105] Fu, J., Xu, D., Liu, Z., Shi, M., Zhao, P., Fu, B., et al. (2007) Increased Regulatory T Cells Correlate with CD8 T-Cell Impairment and Poor Survival in Hepatocellular Carcinoma Patients. Gastroenterology, 132, 2328-2339. [Google Scholar] [CrossRef] [PubMed]
[106] Prawira, A., Xu, H., Mei, Y., et al. (2025) Targeting Treg-Fibroblast Interaction to Enhance Immunotherapy in Steatotic Liver Disease-Related Hepatocellular Carcinoma. Gut, 75, 105-118.
[107] Chuah, S., Lee, J., Song, Y., Kim, H., Wasser, M., Kaya, N.A., et al. (2022) Uncoupling Immune Trajectories of Response and Adverse Events from Anti-PD-1 Immunotherapy in Hepatocellular Carcinoma. Journal of Hepatology, 77, 683-694. [Google Scholar] [CrossRef] [PubMed]
[108] Tzeng, S.F., Yu, Y.R., Park, J., et al. (2025) PLT012, a Humanized CD36-Blocking Antibody, Is Effective for Unleashing Antitumor Immunity against Liver Cancer and Liver Metastasis. Cancer Discovery, 15, 1676-1696. [Google Scholar] [CrossRef] [PubMed]
[109] Seyhan, D., Allaire, M., Fu, Y., Conti, F., Wang, X.W., Gao, B., et al. (2025) Immune Microenvironment in Hepatocellular Carcinoma: From Pathogenesis to Immunotherapy. Cellular & Molecular Immunology, 22, 1132-1158. [Google Scholar] [CrossRef] [PubMed]
[110] Pan, B., Yao, Y., Wu, H., Ye, D., Zhang, Z., Zhang, X., et al. (2025) N-Glycosylated LTβR Increases the Th17/Treg Cell Ratio in Liver Cancer by Blocking RORC Ubiquitination and Foxp3 Transcription. Cell Death & Disease, 16, Article No. 421. [Google Scholar] [CrossRef] [PubMed]
[111] Salié, H., Wischer, L., D’Alessio, A., Godbole, I., Suo, Y., Otto-Mora, P., et al. (2025) Spatial Single-Cell Profiling and Neighbourhood Analysis Reveal the Determinants of Immune Architecture Connected to Checkpoint Inhibitor Therapy Outcome in Hepatocellular Carcinoma. Gut, 74, 451-466. [Google Scholar] [CrossRef] [PubMed]
[112] Fridman, W.H., Pagès, F., Sautès-Fridman, C. and Galon, J. (2012) The Immune Contexture in Human Tumours: Impact on Clinical Outcome. Nature Reviews Cancer, 12, 298-306. [Google Scholar] [CrossRef] [PubMed]
[113] Tian, B., Wang, Z., Cao, M., Wang, N., Jia, X., Zhang, Y., et al. (2025) CCR8 Antagonist Suppresses Liver Cancer Progression via Turning Tumor-Infiltrating Tregs into Less Immunosuppressive Phenotype. Journal of Experimental & Clinical Cancer Research, 44, Article No. 113. [Google Scholar] [CrossRef] [PubMed]
[114] Xu, H., Li, S., Liu, Y., Sung, Y., Zhou, Y. and Wu, H. (2025) A Novel pH-Sensitive Nanoparticles Encapsulating Anti-Pd-1 Antibody and MDK-siRNA Overcome Immune Checkpoint Blockade Resistance in HCC via Reshaping Immunosuppressive TME. Journal of Experimental & Clinical Cancer Research, 44, Article No. 148. [Google Scholar] [CrossRef] [PubMed]