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Arsenic Trioxide Enhances the Efficacy of PD-1 Inhibitors in Hepatocellular Carcinoma by Inducing Immunogenic Cell Death via the ROS/ERS Pathway
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  • Xionghui Wang,
  • Simo Cheng,
  • Yannan Xu,
  • Tianxiao Zheng,
  • Changquan Ling,
  • Juan Du
Xionghui Wang
Changhai Hospital
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Simo Cheng
Naval Medical University
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Yannan Xu
Changhai Hospital
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Tianxiao Zheng
Naval Medical University
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Changquan Ling
Changhai Hospital
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Juan Du
Changhai Hospital

Corresponding Author:[email protected]

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Abstract

Immunotherapy for hepatocellular carcinoma (HCC) often does not achieve the desired results. Immunogenic cell death (ICD) has significant potential to trigger the body’s immune response against tumors, offering a hopeful strategy to improve immunotherapy for HCC. Arsenic trioxide (ATO), which induces ICD, may markedly increase the effectiveness of programmed cell death protein 1 (PD-1) inhibitors in the therapy of HCC. However, the complex mechanisms behind this synergistic effect are not yet fully understood. This study aims to elucidate the functions and mechanisms of ATO in HCC and to explore its potential to enhance immunotherapy for HCC. The results showed that ATO dose-dependently reduced the viability of HCC cells. Concurrently, ATO treatment led to an increase in ROS levels and induced ERS, which activated ICD-related damage associated molecular patterns (DAMPs). As a result, this process prompted dendritic cell maturation and enhanced the tumor immune microenvironment. ATO treatment increased the immunogenicity of HCC cells, allowing them to function as both prophylactic and therapeutic vaccines against HCC and to augment anti-tumor immunity. Finally, ATO was found to improve the effectiveness of PD-1 inhibitors in treating HCC in vivo. Therefore, we conclude that ATO effectively bolstered the body’s immune response by triggering ROS/ERS-mediated ICD, which significantly enhanced the therapeutic effectiveness of PD-1 inhibitors against HCC.
07 Oct 2024Submitted to Immunity, Inflammation and Disease
14 Oct 2024Submission Checks Completed
14 Oct 2024Assigned to Editor
17 Oct 2024Reviewer(s) Assigned
17 Nov 2024Review(s) Completed, Editorial Evaluation Pending
18 Nov 2024Editorial Decision: Revise Major
22 Nov 20241st Revision Received