The destruction of red blood cells by classical complement activation can form erythrocyte ghosts in immune-mediated hemolysis. However, the mechanisms involved in clearing these membrane remnants remain to be elucidated. In this study, a combination of in vivo models, in vitro macrophage co-culture systems, proteomic screening, and functional validation assays was employed to investigate the cellular processing of erythrocyte ghosts. We demonstrated that erythrocyte ghosts are engulfed by macrophage phagocytosis. Besides, a significant downregulation of CD47, a critical "don't-eat-me" signal, is observed on the membranes of erythrocyte ghosts due to ubiquitin-proteasome-mediated degradation, facilitating their phagocytic removal by macrophages. Moreover, the E3 ubiquitin ligase MARCH 1 was identified as the principal mechanistic regulator governing the loss of CD47. These findings uncover a critical pathway for the efficient clearance of hemolytic remnants, offer alternative perspectives on post-hemolytic immune homeostasis, and suggest potential therapeutic avenues for reducing complications associated with hemolysis.
Immunotherapy has improved outcomes in many cancers, yet the clinical benefits remain limited in prostate cancer. We evaluated whether an adenovirus-based bivalent prostate cancer vaccine (Ad-PS2) targeting two tumor antigens could be strengthened by combination with immune checkpoint blockade. Using immunocompetent mouse models, we found that Ad-PS2 combined with low-dose anti-CTLA4 generated robust anti-tumor immunity capable of eliminating established tumors, exceeding the effects of either treatment alone. Tumor-free mice resisted subsequent tumor rechallenge, indicating durable immune protection. Tumor analysis revealed a significant increase in intratumor CD8+ T cell infiltration with Ad-PS2 and anti-CTLA4, whereas anti-PD1 alone produced minimal infiltration and, with the vaccine, provided no therapeutic advantage. These results highlight a mechanistically synergistic interaction between dual antigen-targeted vaccination and CTLA4 blockade and illustrate how rational combination immunotherapy can overcome resistance in prostate cancer. This work defines a strategy that could inform future translational approaches for improving immunologic control of prostate cancer.
[This corrects the article DOI: 10.1016/j.isci.2025.112430.].

