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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jul 15, 2026; 18(7): 121633
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.121633
Letter to the Editor: Spinal IL-33/ST2 blockade for gallbladder carcinoma pain - balancing central analgesia with systemic tumor immune microenvironment risks
Yi Lu, Xin-Lei Zhou, Fan Chen
Yi Lu, Xin-Lei Zhou, The Third Clinical Medical School, The Rehabilitation Medical School, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Fan Chen, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou 310006, Zhejiang Province, China
Co-first authors: Yi Lu and Xin-Lei Zhou.
Author contributions: Lu Y and Zhou XL wrote the original draft, they contributed equally to this article, they are the co-first authors of this manuscript; Chen F reviewed and edited the manuscript; and all authors have read and approved the final manuscript.
AI contribution statement: AI tools (specifically DeepL and ChatGPT) were used solely for linguistic refinement and formatting assistance. I tools were used strictly for language polishing and translation. Crucially, every AI-assisted sentence has been manually reviewed and modified by the author. Furthermore, the final manuscript underwent professional polishing by a certified academic editing agency to ensure quality.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Fan Chen, Researcher, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine, No. 548 Binwen Road, Binjiang District, Hangzhou 310006, Zhejiang Province, China. chenfan@zcmu.edu.cn
Received: March 30, 2026
Revised: April 17, 2026
Accepted: May 19, 2026
Published online: July 15, 2026
Processing time: 98 Days and 16 Hours
Core Tip

Core Tip: This article highlights a critical translational blind spot in targeting the spinal interleukin-33/suppression of tumorigenicity 2 axis for gallbladder carcinoma-induced pain. While local blockade exhibits analgesic efficacy, systemic administration risks impairing CD8+ T cell-mediated intrinsic anti-tumor immunity - a critical risk fundamentally masked by the original study’s use of athymic nude mice. Furthermore, potential tumor-intrinsic suppression of tumorigenicity 2 activation and stromal remodeling necessitate extreme caution. We strongly advocate that future evaluations utilize immunocompetent syngeneic models to compare intrathecal vs systemic delivery, aiming to safely bridge the gap between analgesic mechanisms and the tumor immune microenvironment.

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