All-trans retinoic acid destabilizes ADAR1 protein through retinoylation-mediated USP7 dissociation and improves immunotherapy in pancreatic cancer

  • Nat Commun. 2026 May 11. doi: 10.1038/s41467-026-72271-5.
Ching-Fei Li  1  2 ,  Yongkun Wei  3 ,  Heng-Huan Lee  3  4 ,  Wei-Chao Chang  5 ,  Yun Xiong  6 ,  Yitao Tang  7 ,  Riyao Yang  3  8 ,  Jun Yao  3 ,  Huamin Wang  9 ,  Xiaofei Wang  10 ,  Minghui Liu  3 ,  Jangho Park  10 ,  Jie Fu  3 ,  Ying-Nai Wang  3 ,  Li-Yuan Bai  11 ,  Shao-Chun Wang  5  12  13  14 ,  Cheng-Wei Chou  3  12  15 ,  Jianhua Ling  3 ,  Yu-Yi Chu  3 ,  Zhenzhen Xun  7 ,  Han Liang  7 ,  Anirban Maitra  10 ,  Wantong Yao  10  16 ,  Dihua Yu  3  16 ,  Paul J Chiao  3  16 ,  Haoqiang Ying  17  18 ,  Mien-Chie Hung  19  20  21  22  23
Affiliations
  • 1. Department of Molecular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. [email protected].
  • 2. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. [email protected].
  • 3. Department of Molecular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 4. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 5. Center for Molecular Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
  • 6. Proteomics Core Facility, Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 7. Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 8. The AHMC Dermatology and Research Center, Arcadia, CA, USA.
  • 9. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 10. Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 11. Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, and China Medical University, Taichung, Taiwan.
  • 12. Graduate Institute of Biomedical Sciences, College of Medicine, and Institute of Biochemistry and Molecular Biology, College of Life Sciences, China Medical University, Taichung, Taiwan.
  • 13. Research Center for Cancer Biology, China Medical University, Taichung, Taiwan.
  • 14. Department of Biotechnology, Asia University, Taichung, Taiwan.
  • 15. Division of Hematology/Medical Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
  • 16. The University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
  • 17. Department of Molecular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. [email protected].
  • 18. The University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA. [email protected].
  • 19. Department of Molecular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. [email protected].
  • 20. Center for Molecular Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan. [email protected].
  • 21. Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, and China Medical University, Taichung, Taiwan. [email protected].
  • 22. Graduate Institute of Biomedical Sciences, College of Medicine, and Institute of Biochemistry and Molecular Biology, College of Life Sciences, China Medical University, Taichung, Taiwan. [email protected].
  • 23. Research Center for Cancer Biology, China Medical University, Taichung, Taiwan. [email protected].
Abstract

Adenosine Deaminase acting on RNA 1 (ADAR1) contributes to immunotherapy resistance by suppressing interferon signaling. Therapeutic targeting of ADAR1 has not been achieved to date in clinical settings. Here, we discover all-trans retinoic acid (ATRA) promotes ADAR1 protein degradation in Cancer. In addition, ATRA induces PD-L1 and combination of ATRA and PD-1 blockade reprograms tumor microenvironments to unleash antitumor immunity, thereby impeding tumor growth. Mechanistically, we identify USP7 as a key regulator for ADAR1 protein stability. ATRA disrupts USP7-ADAR1 interaction and promotes ADAR1 ubiquitination and degradation. ATRA leads to ADAR1 retinoylation, which results in disruption of USP7-ADAR1 complex. Our clinical data shows a positive correlation between USP7 and ADAR1 in various types of Cancer. Overall, this study sheds light on control of ADAR1 protein turnover and proposes a mechanism-driven combination therapy using ATRA and PD-1/PD-L1 blockade to convert immunologically "cold" into "hot" Tumors, holding potential for clinical translation.

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