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Immune regeneration: implications for cancer immunotherapy and beyond
Steven L. Reiner
Steven L. Reiner
Published July 1, 2025
Citation Information: J Clin Invest. 2025;135(13):e192731. https://doi.org/10.1172/JCI192731.
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Review

Immune regeneration: implications for cancer immunotherapy and beyond

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Abstract

Cancer care is being transformed by therapies leveraging T lymphocytes to attack tumor cells. In parallel, recent basic discoveries have converged into a framework of lymphocyte-dependent immunity as a regenerative process that is sometimes outstripped by high-level engagement. In a stem cell–like fashion, selected T cells must balance mutually opposing demands of differentiation and self-renewal. Activating versus inhibitory signals to T cells instruct opposing cell metabolism, linked to alternative cell fates that arise in sibling cells through lopsided information transfer. Emerging studies indicate that durable immunotherapy response may be limited by the abundance of self-renewing T cells. Leveraging of basic discoveries of regenerative signaling to bolster sustained, stem-like output of freshly differentiated T cells is offering new strategies to overcome cancer immunotherapy resistance. Lymphocyte regeneration may also sustain harmful autoimmune attack. Undercutting the self-renewal of pathogenic clones may thus emerge as a therapeutic strategy for autoimmune diseases.

Authors

Steven L. Reiner

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Figure 1

Immunity as duality of signaling, cell fate, and response dynamics.

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Immunity as duality of signaling, cell fate, and response dynamics.
(A) ...
(A) Activating signals to T cells, through anabolic metabolism induction (“feast”), drive cell division and functional differentiation (change from red to blue). Inhibitory signals oppose anabolic induction (“famine”) and functional maturation, thereby maintaining self-renewal (red). One cell can yield opposing outcomes in its daughter cells by unequal transmission of activating and inhibitory signals during cell division (color gradient in oval mitotic cell). (B) Activation, division, and differentiation (blue wedge) embody response intensity and narrowing of potential (loss of self-renewal). Self-renewing cells (red wedge) reiteratively remake themselves as they yield differentiated descendants, embodying response durability and multipotency. In the lower plot, inverse relationship between response intensity and durability is a potential vulnerability of cancer immunotherapies that focus on intensifying T cell responses in the setting of imperiled T cell durability. (C) List of mechanistic details in the duality of signaling, cell fate, metabolism, cell biology, and response dynamics. Improving immunotherapy may require creative strategies to contort the natural regenerative balance in order to optimize intensity along with greater durability.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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