Long-chain fatty acid metabolism reprograms antitumor immunity: from molecular mechanisms to clinical translation

Guo Guo1, Huang Xin2, Weng Xiufang2

  • 1School of Basic Medicine, Huazhong University of Science and Technology, Wuhan 430030, China.

Biochemical Pharmacology
|August 20, 2026
PubMed

Insights

Long-chain fatty acid (LCFA) metabolism enzymes and transporters have dual roles in antitumor immunity, offering new therapeutic targets. Strategies must consider cell-type and context to harness beneficial effects while mitigating immunosuppression.

Area of Science:

  • Immunology
  • Metabolic pathways
  • Cancer therapy

Background:

  • Long-chain fatty acids (LCFAs) and their metabolic enzymes/transporters play complex roles in antitumor immunity.
  • Understanding these roles is crucial for developing novel cancer therapies.

Purpose of the Study:

  • To review how LCFA metabolic enzymes and transporters influence antitumor immunity.
  • To explore their cell-type specific dualities and druggability.
  • To assess translational strategies for cancer treatment.

Main Methods:

  • Utilized AlphaFold3 for structural predictions of key enzymes and transporters.
  • Performed molecular docking to map inhibitor interactions.
  • Reviewed existing literature on LCFA metabolism in cancer immunity.

Main Results:

  • LCFA metabolic enzymes and transporters exhibit context-dependent dual roles in immunity, promoting or suppressing antitumor responses.
  • Specific dietary LCFAs like elaidic acid and docosahexaenoic acid enhance antitumor immunity via antigen presentation and ferroptosis.
  • Chronic LCFA accumulation and certain enzymes (e.g., CPT1A, FABP5, CD36) promote immunosuppression and T-cell dysfunction.
  • Tumor-intrinsic ACSL4 can drive proliferation and resistance.

Conclusions:

  • Targeting LCFA metabolic nodes requires cell-type-resolved and context-aware strategies.
  • Therapeutic approaches include enzyme inhibition/activation, transporter blockade, and dietary interventions.
  • Uncoupling opposing immunomodulatory roles of LCFAs is key for effective cancer therapy.

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