在非小细胞肺癌中,代谢-放射性免疫特征预测了治疗反应和免疫重编程
Zihong Zhu1,2,3, Yichen Zan1,2,3, Mengqian Jiang2,4
1Harbin Medical University, Harbin, Heilongjiang, China.
Frontiers in oncology
|November 27, 2025
概括
放射治疗改变了非小细胞肺癌 (NSCLC) 瘤和免疫细胞的新陈代谢,驱动了耐药性. 一个新的基因特征预测了结果,并确定了潜在的放射性敏感剂,以改善治疗.
科学领域:
- 在瘤学瘤学.
- 代谢工程是代谢工程.
- 免疫治疗是一种免疫疗法.
背景情况:
- 放射治疗是非小细胞肺癌 (NSCLC) 治疗的基石.
- 了解瘤微环境 (TME) 中放射治疗诱导的代谢重编程对于克服治疗耐药性至关重要.
- 代谢异质性显著影响治疗反应和患者的结果.
研究的目的:
- 系统地研究放射治疗诱导的NSCLCTM的代谢重塑,包括瘤细胞,免疫细胞和瘤排水淋巴结 (TDLNs).
- 建立基于放射电阻相关代谢基因 (RRMGs) 的预后特征,以优化治疗分层.
- 通过准代谢漏洞来识别新的放射性敏感剂.
主要方法:
- 整合来自NSCLC瘤和TDLN的批量和单细胞转录组数据.
- 使用单细胞流量估计分析 (scFEA) 算法重建代谢流量图.
- 在TCGA放射治疗队列中使用权重基因同表达网络分析 (WGCNA) 和Cox回归来识别核心RRMG.
- 使用CIBERSORT和TIDE算法开发一个预后名录和评估TME特征和免疫治疗反应.
- 放射敏感剂的预测和实验验证.
主要成果:
- 放射治疗诱导了NSCLCTME的显著代谢异质性,抑制了TCA循环和瘤细胞和TDLN中的N-甘氨酸生物合成,并改变了免疫细胞中的血清代谢.
- 七个RRMG (PGD,IDH2,G6PD,ALDH3A1,UPP1,XYLT2,AACS) 被确定为主要的预后决定因素.
- 基于RRMG的风险模型证明了对整体存活率差的可靠预测 (HR=4.726,P<0.001) 和高预测准确性 (1,3,5年AUC:0.752,0.778,0.879).
- 高风险患者表现出免疫抑制性TME,该模型在独立的放射性免疫治疗队列中显示了概括性 (AUC:0.618).
- 实验验证证证实了放射耐性NSCLC细胞中高风险RRMGs的上调,并且确定了ouabain和两个新型化合物作为潜在的放射敏感剂.
结论:
- 在TME中放射治疗诱导的代谢重编程驱动NSCLC耐药性.
- 识别的RRMG签名可以预测放射性免疫疗法的结果,并有助于患者分层.
- 针对像ouabain和新型化合物等药物的代谢脆弱性,提供了一个可翻译的战略,以克服NSCLC耐药性.
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