The innate immune system’s core sensor, the NLRP3 inflammasome (Nucleotide-binding Oligomerization Domain, Leucine-rich Repeat, and Pyrin Domain-Containing Protein 3), is a pivotal multi-protein complex that detects cellular danger and microbial threats. While its activation is fundamental for host defense, chronic dysregulation of NLRP3 is a central driver of pathology in diverse diseases, ranging from neurodegeneration to cancer. This review comprehensively examines the complex and often paradoxical roles of the NLRP3 inflammasome in these two distinct domains. In neurodegenerative disorders, including Alzheimer’s and Parkinson’s, aberrant NLRP3 activation drives persistent neuroinflammation, leading to synaptic dysfunction and neuronal loss through the sustained release of mature IL-1β and IL-18. Conversely, NLRP3 exhibits a striking bimodal role in oncology; it can promote tumorigenesis by fueling chronic inflammation, metastasis, and immune evasion in certain tumor microenvironments, yet simultaneously enhances anti-tumor immunity and pyroptotic cell death in other specific contexts. This context-dependent function highlights a critical therapeutic challenge. We delineate the shared molecular pathways, contrast disease-specific outcomes, and the current landscape of therapeutic strategies aimed at modulating NLRP3. Understanding the nuanced role of the inflammasome offers novel insights into the convergence of chronic inflammation, neurodegeneration, and tumor biology, and holds promise for the development of targeted, context-dependent therapies with dual clinical applications.
Do et al. (2026) studied this question.