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Citalopram exhibits immune-dependent anti-tumor effects by modulating C5aR1+ TAMs.

Fangyuan Dong | Shan Zhang | Kaiyuan Song | Luju Jiang | Li-Peng Hu | Qing Li | Xue-Li Zhang | Jun Li | Mingxuan Feng | Zhi-Wei Cai | Hong-Fei Yao | Rong-Kun Li | Hui Li | Jie Chen | Xiaona Hu | Jiaofeng Wang | Chongyi Jiang | Helen He Zhu | Cun Wang | Lin-Tai Da | Zhi-Gang Zhang | Zhijun Bao | Xu Wang | Shu-Heng Jiang
eLife | 2026

Administration of selective serotonin reuptake inhibitors (SSRIs) is associated with a reduced cancer risk and shows significant anti-tumor effects across multiple tumor types, suggesting the potential for repurposing SSRIs in cancer therapy. Nonetheless, the specific molecular target and mechanism of action of SSRIs remain to be fully elucidated. Here, we reveal that citalopram exerts an immune-dependent anti-tumor effect in hepatocellular carcinoma (HCC). Interestingly, the anti-HCC effects of citalopram are not reliant on its conventional target, the serotonin transporter. Through various drug repurposing approaches, including global reverse gene expression profiling, drug affinity responsive target stability assay, and molecular docking, the complement component 5a receptor 1 (C5aR1) is identified as a new target of citalopram. C5aR1 is predominantly expressed by tumor-associated macrophages, and citalopram treatment enhances local macrophage phagocytosis and elicits CD8+ T anti-tumor immunity. C5aR1 deficiency or depletion of CD8+ T cells hinders the anti-HCC effects of citalopram. Collectively, our study reveals the immunomodulatory roles of citalopram in inducing anti-tumor immunity and provides a basis for considering the repurposing of SSRIs as promising anticancer agents for HCC treatment.

Pubmed ID: 41661166

Associated grants

  • Agency: National Natural Science Foundation of China,
    Id: 82472883
  • Agency: Basic Research-Shanghai Jiao Tong University,
    Id: 21TQ1400225
  • Agency: China Foundation for Youth Entrepreneurship and Employment,
    Id: P24062487785
  • Agency: Clinical Medicine Research Center Construction Project of Huadong Hospital,
    Id: LCZX2202
  • Agency: Shanghai Outstanding Young Medical Personnel Training Program & Excellence Project of Shanghai Municipal Health Commission,
    Id: 20224Z0009
  • Agency: Key Specialized Diseases Construction of Huadong Hospital,
    Id: ZDZB2225
  • Agency: Key Areas Research and Development Programs of Guangdong Province,
    Id: 2023B1111050009
  • Agency: Shanghai Oriental Talent Program - Youth Project,
    Id: QNWS2024017

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