「免疫の霧」を取り除けば診断前の肺がんを阻止できる可能性(Clearing ‘immune fog’ could stop lung cancer before diagnosis)

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2026-10-08 英国研究イノベーション機構(UKRI)

英国のユニバーシティ・カレッジ・ロンドン(UCL)の研究チームは、肺がんの発症前から免疫系に変化が生じ、がん化しかけた細胞の排除を妨げている可能性を明らかにした。研究では、肺がん検診・追跡研究に参加した人々の血液・組織試料とマウスモデルを解析し、免疫反応を抑制する制御性T細胞(Treg)が、肺がんの発症より数か月から数年前に増加することを確認した。この「免疫の霧」は、前がん病変が免疫系に見逃され、腫瘍へ進行する一因と考えられる。試作段階の血液検査でTregを測定すれば、肺がんリスクの上昇や早期病変を捉えられる可能性がある。さらに、Tregの免疫抑制作用を弱める薬剤をマウスに投与した実験では、肺腫瘍を生じる個体の割合が半減し、大きな腫瘍の形成も認められなかった。成果は、発症後の治療に加え、前がん段階で進行を阻止する「がんインターセプション」への道を開く可能性がある。ただし、血液検査や薬剤の有効性を人で確かめるには、さらなる研究が必要である。

<関連情報>

肺がんの予防のための前侵襲性制御性T細胞軸 A preinvasive regulatory T cell axis for lung cancer interception

Samuel Gamble, Zoe E. Whiteman, Claudia Peinador-Marín, Marta Lebrusant-Fernandez, Abigail Y. L. Shurr, Andrei Enica, Teerapon Sahwangarrom, Seng Kuong Anakin Ung, Amber Rogers, Petros Fessas, Chuen Ryan Khaw, Lukas Kalinke, Constantin Ahlmann-Eltze, Ahmed S. N. Alhendi, Kate Otter, Xiuchuan Hu, Krupa Thakkar, Betty Gration, Izzy Newsham, Imran Uddin, Ellen Nuttall Musson, Kyren A. Lazarus, Moritz J. Przybilla, Adam Pennycuick, Pre-Cancer Atlas Team, … James L. Reading
Nature  Published:07 October 2026
DOI:https://doi.org/10.1038/s41586-026-11066-6

Fig. 1: BATF+ effector Treg cells accumulate in premalignant airway lesions.

Abstract

Late-stage non-small cell lung cancer (NSCLC) is rarely curable1, underscoring a need to intervene earlier in the disease process. Growing evidence suggests that antitumour T cell responses are mounted but become progressively dysregulated during early tumorigenesis2,3. Tracking and targeting preinvasive T cell regulation may inform new approaches to detect and intercept lung cancer development. Here we explore how the T cell network is remodelled during NSCLC development via multi-omic, cross-tissue immune profiling in patients with preinvasive lung lesions surveilled by autofluorescence bronchoscopy and computed tomography (CT) imaging. Effector regulatory CD4+ T cells (eTreg cells) expressing basic leucine zipper ATF-like transcription factor (BATF) accumulated in high-grade premalignant airway lesions and were clonally related to circulating eTreg cells. Circulating eTreg cells were increasingly elevated during preinvasive progression, enabling lung tumorigenesis to be tracked through analysis of peripheral blood. Emergence of this clonally coordinated eTreg cell circuit defined rapid progression in patients with early-stage NSCLC detected during CT screening. In mice, carcinogen-driven lung tumorigenesis triggered an analogous preinvasive eTreg cell axis across the blood, airways and draining lymph nodes (dLNs). This culminated in an expansion of lung BATF+ Treg cells and Treg cell-rich peribronchial immature tertiary lymphoid structures (iTLSs). Immune interception via phosphoinositide 3-kinase-δ (PI3Kδ) inhibition abrogated formation of Treg cell-rich iTLSs, reduced circulating and pulmonary Treg cells, increased local conventional type 1 dendritic cells (cDC1s) and reduced lung tumour incidence and size. These data reveal a conserved eTreg cell network that emerges across tissues during early pulmonary tumorigenesis and provide a theranostic framework to track and target preinvasive immune regulation for lung cancer interception.

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