Dysregulated Cholesterol Metabolism and Its Impact on the Tumour Immune Response in Colorectal Cancer.

Colorectal cancer (CRC) ranks among the primary causes of cancer deaths worldwide. Cholesterol metabolism, tightly regulated through biosynthesis, uptake, efflux and conversion, plays a crucial role in CRC development and progression. Dysregulated cholesterol metabolism in cancer cells alters the tumour microenvironment (TME), promoting tumour progression and immune escape. Recent studies highlight the relationship between cholesterol metabolism and the body's immune reactions, showing that cholesterol and its metabolites can modulate immune cell function, driving pro-tumorigenic or anti-tumour effects. Targeting cholesterol metabolism has shown promise in enhancing immunotherapy outcomes, such as inhibiting specific enzymes or transporters to improve T cell infiltration and activation. In this review, we provide a comprehensive overview of the functions of cholesterol and its metabolites in the immune response and the latest advances in CRC therapy targeting cholesterol metabolism.