The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity

CD8+ T cell exhaustion, a critical challenge in the immune response to cancer, is characterized by a profound decline in the functionality of effector CD8+ T cells. This state of exhaustion is accompanied by the upregulation of various inhibitory receptors and significant shifts in both transcriptio...

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Main Authors: Tao Zhong, Shuo Sun, Mingsheng Zhao, Bin Zhang, Huabao Xiong
Format: Article
Language:English
Published: China Anti-Cancer Association 2025-05-01
Series:Cancer Biology & Medicine
Subjects:
Online Access:https://www.cancerbiomed.org/content/22/5/460
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author Tao Zhong
Shuo Sun
Mingsheng Zhao
Bin Zhang
Huabao Xiong
author_facet Tao Zhong
Shuo Sun
Mingsheng Zhao
Bin Zhang
Huabao Xiong
author_sort Tao Zhong
collection DOAJ
description CD8+ T cell exhaustion, a critical challenge in the immune response to cancer, is characterized by a profound decline in the functionality of effector CD8+ T cells. This state of exhaustion is accompanied by the upregulation of various inhibitory receptors and significant shifts in both transcriptional and epigenetic profiles, thus ultimately leading to inadequate tumor control. Therapeutic strategies aimed at reversing CD8+ T cell exhaustion have the potential to rejuvenate immune responses and enhance treatment efficacy. This review compiles current knowledge regarding the molecular mechanisms underlying CD8+ T cell exhaustion, including the roles of immune checkpoint molecules, the tumor microenvironment, metabolic reprogramming, transcription factors, and epigenetic modifications. Emerging therapeutic approaches designed to combat CD8+ T cell exhaustion are evaluated, with emphasis on the modulation of immune checkpoints; targeting of metabolic and transcriptional changes; and exploration of other innovative strategies, such as epigenetic editing and engineered CAR-T cells. Importantly, we expand the exhaustion concept to immune cells beyond CD8+ T cells, such as CD4+ T cells, natural killer cells, and myeloid populations, thereby highlighting the broader implications of systemic immunosuppression in the cancer context. Finally, we propose avenues for future research aimed at further elucidating the factors and molecular mechanisms associated with CD8+ T cell exhaustion, thereby underscoring the critical need for strategies aimed at reversing this state to improve outcomes in cancer immunotherapy.
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series Cancer Biology & Medicine
spelling doaj-art-894d69105b0d4b45bccc5bf94ecc96152025-08-20T03:29:22ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412025-05-0122546048010.20892/j.issn.2095-3941.2024.0628The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunityTao Zhong0Shuo Sun1Mingsheng Zhao2Bin Zhang3Huabao Xiong4Institute of Immunology and Molecular Medicine, Key Laboratory of Cell and Biomedical Technology of Shandong Province, College of Basic Medicine, Jining Medical University, Jining 272067, ChinaCollege of Life Science, Jining Medical University, Rizhao 276826, ChinaInstitute of Immunology and Molecular Medicine, Key Laboratory of Cell and Biomedical Technology of Shandong Province, College of Basic Medicine, Jining Medical University, Jining 272067, ChinaAffiliated Hospital of the Jining Medical University, Jining 272029, ChinaInstitute of Immunology and Molecular Medicine, Key Laboratory of Cell and Biomedical Technology of Shandong Province, College of Basic Medicine, Jining Medical University, Jining 272067, ChinaCD8+ T cell exhaustion, a critical challenge in the immune response to cancer, is characterized by a profound decline in the functionality of effector CD8+ T cells. This state of exhaustion is accompanied by the upregulation of various inhibitory receptors and significant shifts in both transcriptional and epigenetic profiles, thus ultimately leading to inadequate tumor control. Therapeutic strategies aimed at reversing CD8+ T cell exhaustion have the potential to rejuvenate immune responses and enhance treatment efficacy. This review compiles current knowledge regarding the molecular mechanisms underlying CD8+ T cell exhaustion, including the roles of immune checkpoint molecules, the tumor microenvironment, metabolic reprogramming, transcription factors, and epigenetic modifications. Emerging therapeutic approaches designed to combat CD8+ T cell exhaustion are evaluated, with emphasis on the modulation of immune checkpoints; targeting of metabolic and transcriptional changes; and exploration of other innovative strategies, such as epigenetic editing and engineered CAR-T cells. Importantly, we expand the exhaustion concept to immune cells beyond CD8+ T cells, such as CD4+ T cells, natural killer cells, and myeloid populations, thereby highlighting the broader implications of systemic immunosuppression in the cancer context. Finally, we propose avenues for future research aimed at further elucidating the factors and molecular mechanisms associated with CD8+ T cell exhaustion, thereby underscoring the critical need for strategies aimed at reversing this state to improve outcomes in cancer immunotherapy.https://www.cancerbiomed.org/content/22/5/460cd8+ t cell exhaustionimmune checkpointimmune checkpoint inhibitorscancer immunotherapyanti-tumor immunity
spellingShingle Tao Zhong
Shuo Sun
Mingsheng Zhao
Bin Zhang
Huabao Xiong
The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
Cancer Biology & Medicine
cd8+ t cell exhaustion
immune checkpoint
immune checkpoint inhibitors
cancer immunotherapy
anti-tumor immunity
title The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
title_full The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
title_fullStr The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
title_full_unstemmed The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
title_short The mechanisms and clinical significance of CD8+ T cell exhaustion in anti-tumor immunity
title_sort mechanisms and clinical significance of cd8 t cell exhaustion in anti tumor immunity
topic cd8+ t cell exhaustion
immune checkpoint
immune checkpoint inhibitors
cancer immunotherapy
anti-tumor immunity
url https://www.cancerbiomed.org/content/22/5/460
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