Pseudouridine synthase 1-targeted therapy activates antiviral immunity to boost cancer immunotherapy

Pseudouridine is the most abundant epitranscriptomic modification, but its cellular functions remain poorly understood. Here, we identify pseudouridine synthase 1 (PUS1) as a key driver of tumor immune evasion. Specifically, we find that PUS1 is aberrantly overexpressed in tumors and correlates with tumor malignant progression. Notably, genetic ablation of PUS1 effectively suppresses tumor progression, increases T cell infiltration, and boosts T cell function in both MYC/Trp53^-/- mouse liver cancer and chemically induced liver cancer models. Mechanistically, PUS1 loss induces the expression of retrotransposon sequences, resulting in elevated levels of double-stranded RNA (dsRNA) and subsequent activation of innate antiviral immune signaling. Importantly, PUS1 depletion sensitizes tumors to anti-PD-1 therapy in a MYC/Trp53^-/- mouse liver cancer model. Similarly, 5-fluorouracil inhibits pseudouridine synthesis and significantly enhances the efficacy of PD-1 inhibition. Overall, our findings demonstrate PUS1 as a critical regulator of tumor immune evasion, and targeting pseudouridine synthesis can enhance immunotherapy efficacy by activating dsRNA-sensing pathways.