Abstract
In recent years, RNA modifications have been shown to play a key role in regulating immune cell functions, reshaping the tumor immune microenvironment (TIME), mediating immune escape, and influencing the efficacy of immunotherapy. These processes are central to the field of epitranscriptomics. Researchers have discovered various RNA modifications, such as N6-methyladenosine (m(6)A), 5-methylcytosine (m(5)C), N1-methyladenosine (m¹A), N7-methylguanosine (m(7)G), and N4-acetylcytosine (ac(4)C), that dynamically regulate the development, differentiation, activation, and functional state of immune cells through the " writers-readers-erasers " system-a set of enzymes that add, recognize, and remove these modifications-thus contributing to the formation and evolution of the TIME. Furthermore, RNA modification enzymes can serve as predictive markers of general immune responses and are also closely linked to responses to immunotherapy. Accordingly, they have become potential targets for combination therapies. As RNA modification detection technologies advance, researchers are uncovering the spatial heterogeneity and cell-specific regulatory mechanisms of RNA modifications in tumor immunity, which provides new strategies for targeted immunotherapy. However, the regulatory mechanisms of certain RNA modifications on specific immune cells remain unclear, and how to translate research findings into clinical applications also requires further exploration.