MicroRNAs (miRNAs) are pivotal modulators of tumor progression and immune function. Given the central role of the immune system in recognizing and eliminating malignant cells, understanding how miRNAs influence immune responses has become essential for advancing cancer therapy. This review explores the emerging roles of miRNAs in orchestrating cancer immunology, emphasizing their regulation of tumor immune surveillance, immune equilibrium, immune evasion, and immunometabolism. We further illustrate how specific miRNAs modulate the tumor microenvironment by shaping immune cell phenotypes, cytokine networks, and antigen presentation. Some miRNAs enhance cytotoxic T lymphocyte activity, while others promote immune escape by expanding regulatory T cells and myeloid-derived suppressor cells. miRNAs also regulate immune checkpoints (e.g., PD-L1 and CTLA-4), metabolic reprogramming, and stress responses that collectively influence tumor immunogenicity. Additionally, miRNAs are gaining traction as biomarkers for immune activity and predictors of immunotherapy response. Therapeutically, miRNA mimics and inhibitors can enhance anti-tumor immunity, particularly when combined with advanced delivery platforms or immune checkpoint inhibitors. However, challenges such as delivery specificity, off-target effects, and the context-dependent nature of miRNA activity remain significant barriers to clinical translation. Despite shortcomings, miRNAs represent a class of immune regulators with substantial therapeutic potential. Accelerated progress in miRNA-guided therapies is anticipated through deepening insights into miRNA regulatory networks, coupled with integrative multi-omics and AI-driven analytical frameworks. Altogether, miRNAs are a promising frontier in next-generation cancer immunotherapy and precision oncology.
微小核糖核酸（miRNA）是肿瘤进展与免疫功能的关键调控因子。鉴于免疫系统在识别和清除恶性细胞中的核心作用，理解miRNA如何影响免疫应答已成为推动癌症治疗发展的关键。本综述探讨了miRNA在协调癌症免疫学中的新兴作用，重点阐述其对肿瘤免疫监视、免疫平衡、免疫逃逸及免疫代谢的调控机制。我们进一步阐释特定miRNA如何通过塑造免疫细胞表型、细胞因子网络及抗原呈递过程调控肿瘤微环境。部分miRNA能增强细胞毒性T淋巴细胞活性，而另一些则通过扩增调节性T细胞和髓源性抑制细胞促进免疫逃逸。miRNA还调控免疫检查点（如PD-L1和CTLA-4）、代谢重编程及应激反应，共同影响肿瘤免疫原性。此外，miRNA作为免疫活性生物标志物及免疫治疗反应预测因子的应用价值日益凸显。在治疗层面，miRNA模拟物和抑制剂可增强抗肿瘤免疫，尤其当与先进递送平台或免疫检查点抑制剂联用时效果显著。然而，递送特异性、脱靶效应及miRNA活性的环境依赖性等挑战仍是临床转化的主要障碍。尽管存在局限，miRNA仍是一类具有重要治疗潜能的免疫调节剂。通过对miRNA调控网络的深入解析，结合整合多组学与人工智能驱动的分析框架，预计将加速miRNA导向疗法的研发进程。总体而言，miRNA有望成为下一代癌症免疫治疗与精准肿瘤学的前沿领域。
肿瘤(癌症)患者之家