Nasopharyngeal carcinoma (NPC) is a distinct type of head and neck cancer that is highly associated with Epstein-Barr virus (EBV) infection. EBV acts as an epigenetic driver in NPC tumorigenesis, reprogramming the viral and host epigenomes to regulate viral latent gene expression, and creating an environment conducive to the malignant transformation of nasopharyngeal epithelial cells. Targeting epigenetic mechanisms in pre-clinical studies has been shown promise in eradicating tumours and overcoming immune resistance in some solid tumours. However, its efficacy in NPC remains inclusive due to the complex nature of this cancer. In this review, we provide an updated understanding of the roles of epigenetic factors in regulating EBV latent gene expression and promoting NPC progression. We also explore the crosstalk between epigenetic mechanisms and immune evasion in NPC. Particularly, we discuss the potential roles of DNA methyltransferase (DNMT) and histone deacetylase (HDAC) inhibitors in reversing immune suppression and augmenting antitumour immunity. Furthermore, we highlight the advantages of combining epigenetic therapy and immune checkpoint inhibitor to reverse immune resistance and improve clinical outcomes. Epigenetic drugs have the potential to modulate both epigenetic mediators and immune factors involved in NPC. However, further research is needed to fully comprehend the diverse range of epigenetic modifications in NPC. A deeper understanding of the crosstalk between epigenetic mechanisms and immune evasion during NPC progression is crucial for the development of more effective treatments for this challenging disease.

Graphical Abstract

中文翻译：

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针对鼻咽癌表观遗传修饰和免疫逃避的串扰

鼻咽癌 (NPC) 是一种独特的头颈癌，与 Epstein-Barr 病毒 (EBV) 感染高度相关。EBV在鼻咽癌肿瘤发生中充当表观遗传驱动因素，重新编程病毒和宿主表观基因组以调节病毒潜伏基因表达，并创造有利于鼻咽上皮细胞恶性转化的环境。临床前研究中针对表观遗传机制已显示出在根除肿瘤和克服某些实体瘤中的免疫抵抗方面的前景。然而，由于鼻咽癌的复杂性，其疗效仍然具有包容性。在这篇综述中，我们对表观遗传因素在调节 EBV 潜伏基因表达和促进 NPC 进展中的作用提供了最新的认识。我们还探讨了鼻咽癌表观遗传机制与免疫逃避之间的串扰。我们特别讨论了 DNA 甲基转移酶 (DNMT) 和组蛋白脱乙酰酶 (HDAC) 抑制剂在逆转免疫抑制和增强抗肿瘤免疫力方面的潜在作用。此外，我们强调了表观遗传疗法和免疫检查点抑制剂相结合在逆转免疫抵抗和改善临床结果方面的优势。表观遗传药物有可能调节鼻咽癌中涉及的表观遗传介质和免疫因子。然而，需要进一步的研究来充分理解鼻咽癌中各种表观遗传修饰。更深入地了解 NPC 进展过程中表观遗传机制和免疫逃避之间的串扰对于开发针对这种具有挑战性的疾病的更有效的治疗方法至关重要。

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