The cyclic GMP-AMP synthase (cGAS)–stimulator of interferon genes (STING) pathway, the core DNA-sensing mechanism in innate immunity, plays a pivotal role in linking tumorigenesis and the immune response. This review systematically elucidates the molecular activation mechanisms of this pathway and its complex regulatory networks within tumors, with a particular focus on analyzing its dual functions—tumor immune surveillance versus tumor promotion—and the determining factors involved. Current research indicates that acute activation of the cGAS–STING pathway potently suppresses tumors by inducing type I interferon responses, thereby promoting dendritic cell (DC) maturation and cytotoxic T lymphocyte infiltration. However, its chronic, persistent activation can paradoxically accelerate tumor progression and immune evasion by remodeling the immunosuppressive tumor microenvironment (TME), inducing chronic inflammation, and enhancing the intrinsic malignant phenotypes of tumor cells. Tumor cells tightly regulate the activity of this pathway through multiple mechanisms, including epigenetic silencing, aberrant post-translational modifications, autophagy-dependent degradation, and tumor microenvironment remodeling. Based on these findings, this review comprehensively summarizes therapeutic strategies targeting the cGAS–STING pathway. These include the latest advancements in STING agonist development, optimization strategies for combination therapies, and innovative applications of nano-delivery systems. Furthermore, we delve into the critical challenges hindering current clinical translation, including pharmacokinetic limitations, mechanisms of tumor resistance, STING genetic polymorphisms, and safety concerns. Finally, we explore future research directions, encompassing precision modulation strategies, personalized therapeutic approaches, and novel delivery systems, aiming to provide a theoretical foundation and innovative insights for the next generation of cancer immunotherapies centered on the cGAS–STING pathway.
Haiyan Jiang, Zhanzhan Li, Xia Li et al.· Frontiers in Pharmacology· 1 citation
Parkinson's disease (PD) is a common neurodegenerative disorder. It is characterized by the progressive loss of dopaminergic neurons in the midbrain substantia nigra and the abnormal aggregation of α-synuclein. In recent years, ERS and the triggered UPR have been identified as a central role connecting multiple pathogenic factors in PD. This review systematically elaborates on the key pathological roles and molecular mechanisms of ERS in PD. In PD, various factors including genetic mutations, environmental toxins, and oxidative stress can disrupt ER homeostasis. These disruptions activate the UPR, which is mediated by the PERK, IRE1α, and ATF6 signaling pathways. A moderate UPR aims to restore cellular homeostasis. However, persistent or severe ERS can switch irreversibly to pro-apoptotic pathways, leading to neuronal death. More importantly, ERS interacts extensively with other PD-related pathological processes. It forms complex positive feedback loops with other core pathological processes in PD. These processes include the abnormal aggregation and propagation of α-synuclein, mitochondrial dysfunction, neuroinflammation, and impaired autophagic flux. Together, they drive the progressive neurodegeneration. Given its central role, targeting ERS has become a potential therapeutic strategy. This article focuses on discussing various intervention approaches, their research progress, and associated challenges. These include: UPR pathway-specific modulators; chemical chaperones; enhancers of protein degradation systems; existing drugs and natural products with ERS-modulating effects; neurotrophic factors and gene therapy; and traditional Chinese medicine. Finally, we discuss future research directions, including developing central nervous system-selective drugs, utilizing precision medicine for personalized treatment, and exploring combination therapies. The aim is to provide new perspectives for disease-modifying treatments of PD.
Xin Chen, Zihao Zhao, Xinlei Yao et al.· Biochemical Pharmacology· 3 citations