Besides BMPR1B, VSTM4, a secreted protein that can reduce IFN-γ, IL-2, and IL-17 cytokine production by human T cells and cause a profound decrease in T cell activation [66], was negatively correlated with CD4_4 density but positively associated with STS, suggesting that CAF-derived VSTM4 modulates CD4_4 activity and subsequently leads to poor survival rates in patients with HGSC. Here, VSTM4 is linked to telomere syndrome.