ISCU-p53 axis orchestrates macrophage polarization to dictate immunotherapy response in esophageal squamous cell carcinoma

作者：Jialiang Luo, Xu Zhang, Zhicheng Liang, Weitao Zhuang, Mingxin Jiang, Min Ma, Shuying Peng, Shujie Huang, Guibin Qiao, Qingyun Chen · 发表于：Cell Death and Disease · 年份：2025 · DOI：10.1038/s41419-025-07787-7 · 被引用次数：8 · 研究领域：Epigenetics and DNA Methylation、Immune cells in cancer、Esophageal Cancer Research and Treatment

Abstract Immunological heterogeneity in esophageal squamous cell carcinoma (ESCC) poses a significant challenge to the efficacy and response to immunotherapy. In this study, we used single-cell RNA sequencing to uncover substantial heterogeneity in the tumor microenvironments (TMEs) among patients received PD-1 inhibitor with partial response (PR), stable disease (SD), and that who underwent surgery without prior therapy. Notably, tumors classified as SD demonstrated an immunosuppressive environment, characterized by a higher prevalence of M2-like macrophages and lower frequencies of T and B cells, especially PD1 high CD8 + T cells. These PD1 high CD8 + T cells were found to frequently engage with macrophages within the TMEs. Focusing on macrophages, we observed elevated expression of the Iron-Sulfur Cluster Assembly Enzyme (ISCU) in macrophages infiltrating SD tumors. ISCU was identified as a promoter of M2 macrophage polarization in a p53-dependent manner. Mechanistically, ISCU sequestrates p53 in the cytoplasm, reducing its nuclear location and relieving transcriptional repression of xCT and Arg1. Consequently, the increased expression of xCT and Arg1 modulates macrophage sensitivity to ferroptosis and the arginine metabolic pathway, thus affecting macrophage differentiation and inflammatory responses. Furthermore, inhibition of ISCU expression was found to repolarize macrophages, enhance CD8 + T cell cytotoxicity, and boost the efficacy of anti-PD-1 antibody. Collectively...