复旦大学×上海交大合作Cell论文：癌细胞通过劫持痛觉神经，实现免疫逃逸

Core Viewpoint - The research reveals a novel mechanism by which cancer cells evade immune surveillance by hijacking pain-sensing neurons, leading to systemic immune suppression in tumor-draining lymph nodes (TDLN) and providing insights for enhancing immunotherapy and pain relief strategies [3][4][18]. Group 1: Research Findings - Under immune pressure, cancer cells activate pain-sensing neurons through the ATF4-SLIT2 signaling axis, which leads to the remodeling of TDLN into an immunosuppressive environment [6][14]. - The study found that higher densities of pain-sensing neurons in tumors correlate with worse immune system status in patients, characterized by increased M2 macrophages and decreased CD8+ T cells [9][20]. - The activation of pain-sensing neurons in TDLN releases calcitonin gene-related peptide (CGRP), which suppresses anti-tumor immune responses, resulting in a decrease in CD8+ T cells and impaired dendritic cell function [14][15]. Group 2: Treatment Strategies - The research proposes several methods to disrupt the neuroimmune circuit, including gene knockout of SLIT2 or ATF4, chemical denervation of pain-sensing neurons, and the use of CGRP receptor antagonists like remifentanil, which enhance the efficacy of immune checkpoint inhibitors [18][19]. - These strategies not only inhibit tumor growth but also provide dual benefits of pain relief and enhanced anti-tumor immunity [18][19]. Group 3: Clinical Implications - The study suggests that cancer pain may serve as an important indicator of immune evasion, prompting clinicians to monitor pain levels as a potential measure of immunotherapy effectiveness [20]. - Existing drugs like remifentanil could be repurposed for cancer treatment, offering cost-effective options for patients [21]. - The findings indicate the potential for personalized treatment approaches based on individual neuroimmune characteristics, and the mechanism may apply to various cancer types beyond head and neck squamous cell carcinoma [22][23].