Immune remodeling in inflammatory bowel disease-associated colorectal cancer: Mechanisms and immunotherapeutic implications (Review)
7 affiliations
- 1The Second Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, P.R. China
- 2Department of Anorectal Surgery, Second Affiliated Hospital, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110034, P.R. China
- 3Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
- 4School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, P.R. China
- 5Department of Anorectal Surgery, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, P.R. China
- 6Ninth School of Clinical Medicine, Peking University, Beijing 100038, P.R. China
- 7Administrative Office, Second Affiliated Hospital, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110034, P.R. China
Abstract
Inflammatory bowel disease-associated colorectal cancer (IBD-CRC) arises in the setting of long-standing chronic intestinal inflammation, in which immune dysregulation cannot be readily attributed to the dominance of a single inhibitory pathway or to global immunosuppression. Persistent inflammatory signaling sustains a state of prolonged immune engagement, yet with constrained effector output, potentially compromising antitumor immune surveillance and limiting the clinical benefit of immunotherapy. The present review synthetises the accumulated knowledge on the long-term immunological alterations induced by chronic inflammation, including the integration of immune signaling, shifts in activation thresholds, metabolic reprogramming, and functional polarization of immune cells. These changes are discussed in the context of both tumor initiation and tumor maintenance to delineate the immunological evolution of IBD-CRC. The review further examines the relationship between inflammation-induced response constraints and the limited efficacy of immune checkpoint inhibitors, and summarizes the mechanistic barriers to immunotherapy in IBD-CRC. Collectively, these observations suggest that relieving inhibition through a single target may be insufficient to restore effective antitumor immunity. Finally, the potential value of natural plant-derived interventions characterized by multi-component, low-intensity, and long-term modulation is discussed, particularly with respect to reducing inflammatory burden and improving immune metabolic states, thereby providing a conceptual basis for the development of combination immunotherapeutic strategies.
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BibTeX
@article{zhang2026immune,
title = {{Immune remodeling in inflammatory bowel disease-associated colorectal cancer: Mechanisms and immunotherapeutic implications (Review)}},
author = {Tao Zhang and Zhetan Ren and Ling Wang and Ru Man and Lin Wang and Jing Wang and Xiaozhen Cheng and Jirun Peng and Yongduo Yu},
journal = {International Journal of Molecular Medicine},
year = {2026},
month = oct,
doi = {10.3892/ijmm.2026.6024},
url = {https://doi.org/10.3892/ijmm.2026.6024},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Immune remodeling in inflammatory bowel disease-associated colorectal cancer: Mechanisms and immunotherapeutic implications (Review)
AU - Tao Zhang
AU - Zhetan Ren
AU - Ling Wang
AU - Ru Man
AU - Lin Wang
AU - Jing Wang
AU - Xiaozhen Cheng
AU - Jirun Peng
AU - Yongduo Yu
PY - 2026
DA - 2026/10/22
JO - International Journal of Molecular Medicine
DO - 10.3892/ijmm.2026.6024
UR - https://doi.org/10.3892/ijmm.2026.6024
AB - Inflammatory bowel disease-associated colorectal cancer (IBD-CRC) arises in the setting of long-standing chronic intestinal inflammation, in which immune dysregulation cannot be readily attributed to the dominance of a single inhibitory pathway or to global immunosuppression. Persistent inflammatory signaling sustains a state of prolonged immune engagement, yet with constrained effector output, potentially compromising antitumor immune surveillance and limiting the clinical benefit of immunotherapy. The present review synthetises the accumulated knowledge on the long-term immunological alterations induced by chronic inflammation, including the integration of immune signaling, shifts in activation thresholds, metabolic reprogramming, and functional polarization of immune cells. These changes are discussed in the context of both tumor initiation and tumor maintenance to delineate the immunological evolution of IBD-CRC. The review further examines the relationship between inflammation-induced response constraints and the limited efficacy of immune checkpoint inhibitors, and summarizes the mechanistic barriers to immunotherapy in IBD-CRC. Collectively, these observations suggest that relieving inhibition through a single target may be insufficient to restore effective antitumor immunity. Finally, the potential value of natural plant-derived interventions characterized by multi-component, low-intensity, and long-term modulation is discussed, particularly with respect to reducing inflammatory burden and improving immune metabolic states, thereby providing a conceptual basis for the development of combination immunotherapeutic strategies.
SN - 1107-3756
SN - 1791-244X
ER -