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Chinese Journal of Injury Repair and Wound Healing(Electronic Edition) ›› 2026, Vol. 21 ›› Issue (03): 236-240. doi: 10.3877/cma.j.issn.1673-9450.2026.03.011

• Review • Previous Articles    

Research progress on the role of regulatory network of PANoptosis in remodeling the immune microenvironment and reversing drug resistance in melanoma

Fujun Wang1, Yongjian Chen2, Ziqiang Wang3, Xinbei Cheng4, Ronghua Yang3,()   

  1. 1 School of Basic Medical Sciences, Qiqihar Medical University, Qiqihar 161006, China
    2 First Clinical Medical College, Guangdong Medical University, Zhanjiang 524023, China
    3 Department of Burn and Plastic Surgery, the Second Affiliated Hospital of South China University of Technology, Guangzhou 510180, China
    4 School of Nursing, Qiqihar Medical University, Qiqihar 161006, China
  • Received:2026-02-22 Online:2026-06-01 Published:2026-06-01
  • Contact: Ronghua Yang

Abstract:

Malignant melanoma frequently develops resistance to targeted agents and immune checkpoint blockade. The core reason lies in the impaired ability of malignant cells to undergo regulated cell death, along with the dominance of an immunosuppressive microenvironment, which limits the efficacy of solely targeting mitochondrial apoptosis. PANapoptosis integrates pyroptosis, apoptosis, and necroptosis, thereby enhancing tumor cell clearance, promoting the release of adenosine triphosphate (ATP) and antigens, and amplifying inflammatory and interferon signaling. These effects improve antigen presentation and effector immune cell recruitment, ultimately enhancing responses to immunotherapy. However, factors such as hypoxia, acidic environment, enhanced autophagy, and epigenetic silencing can hinder the initiation and amplification of PANapoptosis. This review summarizes the molecular architecture of PANapoptosis and its impact on the immune microenvironment of melanoma, as well as relevant resistance mechanisms, proposes that B-cell lymphoma 2-related protein A1 (BCL2A1) may play a negative regulatory role by inhibiting the PANapoptotic complex, and explores the potential of combining BCL2A1 targeting with PANapoptosis inducers as a direction for overcoming therapeutic resistance in melanoma.

Key words: Melanoma, PANoptosis, Immune microenvironment, B-cell lymphoma 2-related protein A1

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