Targeting CB1 and TRPM8 receptors to counteract CD8+ T cell exhaustion

  • Sci Rep. 2026 Apr 10;16(1):16876. doi: 10.1038/s41598-026-46794-2.
Adel Mohammadzadeh  1  2 Sahand Moazzendizzaji  3 Aliasghar Tabatabaei Mohammadi  4 Afsaneh Ahmadi  5 Rahim Mahmodlou  6 Ali Akbar Pourfathollah  7  8
Affiliations
  • 1. Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran. [email protected].
  • 2. Department of Immunology and Genetics, Urmia University of Medical Sciences, Urmia, Iran. [email protected].
  • 3. Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
  • 4. School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
  • 5. Department of Infectious Diseases, Immigrant Health Clinic, Copenhagen University Hospital, Hvidovre, Denmark.
  • 6. Department of General Surgery, Urmia University of Medical Sciences, Urmia, Iran.
  • 7. Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
  • 8. Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
Abstract

The prolonged interaction between the immune system and tumor antigens can result in T cell exhaustion. Extensive research has been conducted on strategies to reactivate exhausted T cells within the tumor microenvironment. However the exact contribution of the endocannabinoid system (ECS) and nociceptors in regulating CD8+ T cells within the framework of cancer-related inflammation has not been thoroughly studied. This study investigated the use of a TRPM8 antagonist (RQ-00203078), a selective Cannabinoid Receptor 1 (CB1) antagonist (AM251), and alpelisib (BYL-719) to control CD8+ T cell exhaustion. Our findings showed that administration of the CB1 Antagonist AM251, either alone or in combination with alpelisib, significantly reduced the expression of PD-1 and LAG-3 on CD8+ T cells. Interestingly, treatment with the TRPM8 antagonist led to a notable increase in PD-1 expression on CD8+ T cells. These findings suggest that the decreased expression of inhibitory receptors on CD8+ T cells after treatment with the CB1 Antagonist whether alone or with alpelisib and TRPM8 highlights the potential of ECS as a promising therapeutic target in Cancer treatment.

Keywords
Alpelisib; CB1 and TRPM8 antagonists; CD8+ T cell exhaustion; Neuro-immune interaction; Nociceptors; PD-1 and Lag-3.
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