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MDSCs 在肿瘤免疫治疗中的研究进展

Research progress of MDSCs in tumor immunotherapy

来源期刊: 广州医药 | 151-159 发布时间:2025-02-20 收稿时间:2025/3/11 12:00:21 阅读量:58
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关键词:
肿瘤免疫治疗免疫逃逸髓系来源抑制性细胞联合治疗
tumor immunotherapyimmune evasionmyeloid-derived suppressor cells(MDSCs)combination therapy
DOI:
10.20223/ j.cnki.1000-8535.2025.02.002
收稿时间:
2024-07-23 
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0  
       实体瘤对免疫治疗应答非常有限,因此,如何有效提升肿瘤免疫治疗的疗效,已成为当前肿瘤免疫治疗领域亟待解决的关键难题与挑战。髓系来源抑制性细胞(MDSCs)的趋化募集及其所介导的肿瘤免疫逃逸机制,是制约实体瘤免疫治疗效果的核心因素之一。文章深入探讨了MDSCs的起源、表型特征、其介导肿瘤免疫逃逸的具体机制,以及当前针对MDSCs的靶向治疗策略与将MDSCs靶向疗法与肿瘤免疫治疗相结合的最新研究进展。此外,文章还系统性地分析了靶向MDSCs联合免疫治疗策略所面临的关键挑战,并据此提出了MDSCs的精准靶向策略。这一策略旨在精确激活抗肿瘤免疫反应,为癌症患者提供更为个性化、高效的治疗方案,从而开启肿瘤免疫治疗领域的新纪元,为癌症治疗策略的创新与发展贡献力量。
  Solid tumors exhibit a very limited response to immunotherapy.Consequently,effectively enhancing the therapeutic efficacy of tumor immunotherapy has emerged as a critical challenge and problem that urgently needs to be addressed in tumor immunotherapy.The chemotaxis and recruitment of myeloid-derived suppressor cells(MDSCs)and the tumor immune evasionmechanisms mediated by them are one of the core factors that significantly restrict the efficacy of immunotherapy for solid tumors.In this review,we discuss the origins and phenotypic characteristics of MDSCs,the specific mechanisms by which they mediate tumor immune evasion,as well as current targeted therapeuticstrategies for MDSCs and the latest research progress in combining MDSC-targeted therapy with tumor immunotherapy.Furthermore,we  have  systematically analyzed the  key challenges faced by the combination of MDSC-targeted and immunotherapy strategies,and accordingly proposed a precise targeting strategyfor MDSCs.This strategy aims to precisely activate anti-tumor immune responses,providing more personalized and efficienttreatment options for cancer patients,thereby opening a new era in tumor immunotherapy and contributing to the innovation anddevelopment of cancer treatment strategies.
       尹亭亭   博士,广州市第一人民医院医学研究与创新转化中心专职科研人员,获得“2023年度广州市卫健委优秀人才”称号。长期从事肿瘤免疫微环境探究,致力于寻找提高实体肿瘤治疗效果的新靶标,以及免疫治疗组合方式,相关研究成果以第一作者身份发表在Cancer Research杂志,同期发表了领域专家的评述并重点推荐。目前主持国家自然科学基金1项,省部级课题2项。

       近年来,肿瘤免疫治疗发展迅猛,以程序性细胞死亡受体1(programmed death 1,PD-1)及其配体(programmed death-ligand 1,PD-L1)的抗体为代表的免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)已成为肿瘤治疗的重要手段。尽管如此,当前实体瘤的免疫治疗,特别是单一免疫疗法的应用,仍面临有效率相对较低的挑战。髓系来源抑制性细胞(myeloid-derived  suppressor cells,MDSCs)被公认为肿瘤免疫治疗过程中的主要障碍,它们不仅能够直接抑制抗肿瘤免疫反应,还具备诱导其他免疫抑制细胞产生的能力,从而进一步阻碍了治疗的有效性。为了克服这一难题,研究者们提出了ICIs与MDSCs靶向治疗相结合的联合治疗策略,这些策略被证实能够有效抑制肿瘤的发生与进展,为肿瘤免疫治疗开辟了新的希望之路。鉴于人源性MDSCs的复杂构成与高度异质性,我们强调深入探索MDSCs在不同类型肿瘤中的独特表型与特性的关系,这一研究不仅是解锁精确清除MDSCs方法的关键,更是推动开发更为精准的个体化肿瘤免疫治疗方案不可或缺的基石。

1  肿瘤免疫治疗挑战:肿瘤免疫逃逸

       肿瘤免疫治疗是继手术、放射治疗(放疗)、化学治疗(化疗)等传统治疗方法后快速发展的新一代肿瘤治疗方法,具有巨大的临床应用前景。这种治疗方法主要通过主动或被动方式使机体产生肿瘤特异性免疫应答,发挥抑制和杀伤肿瘤细胞的作用。当前,肿瘤免疫治疗的主要策略包括细胞因子疗法、肿瘤疫苗、溶瘤病毒疗法(oncolytic virus therapy,OVT)、过继细胞免疫疗法(adoptive cell therapy,ACT)、ICIs[1]。目前临床研究和应用比较多的是ICIs疗法,抗细胞毒性T淋巴细胞相关蛋白4(cytotoxic T-lymphocyte-associated protein 4,CTLA-4)的抗体Ipilimumab、针对PD-1/PD-L1的抗体Pembrolizumab和Tezolizumab已被美国食品药品监督管理局(FDA)批准用于治疗多种类型的肿瘤,包括黑色素瘤、膀胱癌和肺癌等[2]。2013年《科学》杂志将肿瘤免疫治疗评选为年度十大科学突破之首,然而其临床疗效依然有限,如抗PD-1/PD-L1抗体针对前列腺癌、卵巢癌、食管癌、胰腺癌等多种实体肿瘤治疗的临床总体反应率均低于30%[3]。因此,实体瘤的免疫治疗仍面临巨大挑战。
       实体瘤免疫疗法最大的瓶颈是肿瘤免疫逃逸(tumor immune evasion),肿瘤免疫逃逸是指肿瘤细胞通过多种机制逃避机体免疫系统识别和攻击,从而得以在体内生存和增殖的现象[4]肿瘤免疫逃逸的机制包括限制抗原识别,以及诱导免疫抑制性细胞生成形成免疫抑制性肿瘤微环境(tumor microenvironment,TME)[5]在TME中,免疫抑制性细胞扮演着关键角色,包括但不限于肿瘤相关巨噬细胞(tumor-associated macrophages,TAMs)、调节性T细胞(regulatory T cells,Tregs)和髓系来源性抑制细胞(MDSCs)。TAMs通过释放免疫抑制性细胞因子如转化生长因子β(transforming growth factor-β,TGF-β)和白细胞介素10(interleukin-10,IL-10),以及促进血管生成的因子如血管内皮生长因子(vascular endothelial growth factor,VEGF)和成纤维细胞生长因子(fibroblast growth factor,FGF),加速肿瘤细胞的增殖和侵袭能力[6]。Tregs则直接抑制CD8+ T细胞的功能,其数量与患者预后呈负相关,是肿瘤免疫逃逸中的重要一环[7]。MDSCs则通过产生精氨酸酶1(arginase 1,Arg1)、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)和TGF-β等分子,不仅抑制抗肿瘤免疫反应,还促进Tregs的生成,进一步加剧免疫抑制状态[8]因此,靶向这些免疫抑制细胞和相关信号是逆转肿瘤免疫逃逸和提高免疫治疗效果潜在的途径。

2  MDSCs 在肿瘤免疫逃逸中的作用

2.1 MDSCs的来源与分类

       MDSCs是一类源自骨髓的未成熟、高度异质且具有显著免疫抑制功能的髓系细胞。它们能够有效地抑制T细胞和自然杀伤(nature killer,NK)细胞的功能,这在肿瘤免疫逃逸过程中尤为重要[9]。在正常生理状态下,髓系前体细胞会逐步分化为未成熟骨髓细胞(immature myeloid cell,IMC),这些IMC随后迁移至外周器官,最终发育为成熟的巨噬细胞、树突状细胞(dendritic cell,DC)及粒细胞。然而,在慢性炎症或肿瘤存在的环境中,肿瘤细胞不断释放一系列刺激性信号,如巨噬细胞集落刺激因子(macrophage colony-stimulating factor,M-CSF)、粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony-stimulating factor,GM-CSF)及干细胞因子等,这些信号会扰乱正常的骨髓造血过程,导致IMC异常增殖并抑制其向成熟粒细胞和单核细胞的正常分化。这群滞留于未成熟状态的IMC正是MDSCs的前身[10]。尽管上述信号足以扩增具有MDSCs样表型的细胞群体,但这一群细胞不一定具备免疫抑制功能,还需要其它促炎细胞因子包括IL-6、IL-1β、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、IL-13、IL-4、干扰γ(interferon-γ,IFN-γ)等调节MDSCs的活[11]。此外,MDSC细胞能够响应体内多种驱化信号,随后迁移至淋巴组织、肿瘤病灶以及潜在的转移前微环境中。在这一过程中,由肿瘤细胞特异性分泌的多种趋化因子,如CC趋化因子配体2(C-C motif chemokine ligand 2,CCL2)、CCL5、CXC趋化因子配体5(C-X-C motif chemokine 5,CXCL5)、CXCL12等,发挥着至关重要的作用。它们能够吸引MDSCs穿越血管壁,进入TME,从而增强局部免疫抑制效应[12]
       MDSCs根据其表型和形态特征可以分成两个亚群:多形核MDSC(polymorphonuclear MDSC,PMN-MDSC)和单核MDSC(monocytic MDSC,M-MDSC)。在大多数肿瘤中,PMN-MDSC占总MDSC群体的70%~80%,而 M-MDSC通常不超过20%。在小鼠模型中,PMN-MDSC通常定义为CD11b+ Ly6G+ Ly6Clo细胞,形态上类似于中性粒细胞,而M-MDSC为CD11b+ Ly6GLy6Chi胞,形态上更接近于单核细胞[13]。在人类中,PMN-MDSC被定义为CD11b+ CD33+ CD14CD15+细胞,而M-MDSC为CD11b+ CD33+ CD14+ CD15细胞[14]。尽管PMN-MDSC与中性粒细胞在形态上相似,但它们在功能上存在显著差异。PMN-MDSC能够抑制T细胞的功能,并展现出独特的基因表达谱。与中性粒细胞相比,PMN-MDSC的吞噬能力较低,但具有较高的Arg-1、髓过氧化物酶(myeloperoxidase,MPO)和活性氧(reactive oxygen species,ROS)活性[15]。另一方面,M-MDSC与正常单核细胞相比,下调人类白细胞抗原DR(human leukocyte antigen DR,HLA-DR)表达,能够通过Arg1、一氧化氮(nitric oxide,NO)等机制介导T细胞功能的抑制[16]。此外,还存在一些非典型的MDSCs。一些未成熟的髓系细胞同样有着免疫抑制功能,称为早期MDSCs(early-stage MDSCs,eMDSCs),表型为Lineage-CD33+ HLA-DR−[16]。在转移性小儿肉瘤患者的外周血中可以观察到一群表型为CD11b+ HLA-DR+MDSCs,这群细胞同时具备纤维细胞表型,称为F-MDSCs(fibrocytic MDSCs),能够通过吲哚胺氧化酶(indolearmine 2,3-dioxygenase,IDO)途径对T细胞起到抑制作用[17]

2.2 MDSCs发挥免疫逃逸作用的机制

       MDSCs介导的免疫抑制主要机制包括:(1)表达免疫检查点分子。TME中的缺氧和IFN-γ能够上调MDSCs上PD-L1的表达,MDSCs的PD-L1能够通过与T细胞上PD-1的相互作用来抑制T细胞效应性功能[18-19]。MDSCs也可以表达VISTA(V-domain Ig suppressor of T-cell activation)和Gal-9(galectin-9),通过VISTA/VISTAL[20]Gal-9/TIM-3[21]途径起到促进肿瘤免疫逃逸的作用。(2)消耗T细胞所必需的氨基酸。MDSCs中Arg1表达的增加导致L-精氨酸的显著消耗,进而使T细胞因缺乏L-精氨酸而停滞在G0-G1细胞周期阶段[22]。除了Arg1外,MDSCs还表达iNOS,该酶同样能够分解L-精氨酸,其主要产物NO也被证明能够诱导T细胞功能耗竭[16]。T细胞活化需要抗原提呈细胞(antigen-presenting cell,APC)提供的半胱氨酸,MDSCs可以吸收半胱氨酸但不会排出,从而竞争性抑制APC对T细胞的活化作[23]。MDSCs还显著表达IDO,该酶负责将L-色氨酸转化为N-甲酰基犬尿氨酸,引起TME中色氨酸的缺乏,进而导致T细胞的细胞周期受阻,并诱导T细胞功能耗竭[24]。(3)产生ROS与活性氮(reactive nitrogen species,RNS)。MDSCs能产生高水平的ROS,这些ROS不仅诱导T细胞凋亡[10,25],还已被证实能够下调T细胞受体(T cell receptor,TCR)的ζ链的表达,进而破坏TCR信号传导[26]。MDSCs能表达产生RNS,RNS能通过硝化T细胞的淋巴细胞特异性蛋白酪氨酸激酶(lymphocyte protein tyrosine kinase,LCK)从而抑制T细胞活化[27]。(4)MDSCs还分泌免疫抑制性细胞因子TGF-β和IL-10,这些因子不仅抑制抗肿瘤免疫中效应T细胞的功能,还招募免疫抑制性的Treg细胞[28]。(5)MDSCs可以产生细胞外腺苷。部分MDSCs高表达CD39和CD73,能够将细胞外的ATP和AMP转化为腺苷,从而抑制T细胞和NK细胞的活性[29]。(6)MDSCs还可通过下调NK细胞表面活化受体 NKp30、NKG2D、NKp46 的表达介导NK细胞的功能抑制[30]

3  靶向 MDSCs 的治疗策略

       肿瘤的免疫治疗策略核心在于消除由多种因素所诱发的免疫抑制状态,以恢复和提升机体免疫系统对肿瘤细胞的攻击能力。近年来,靶向MDSCs已成为肿瘤治疗研究领域内的热点话题。通过靶向MDSCs以消除其在TME中对免疫细胞的抑制作用,被视为一种根除肿瘤的有效且可行的策略。目前靶向MDSCs的策略主要围绕以下三个方面:直接清除MDSCs,抑制MDSCs的免疫抑制功能,和诱导MDSCs分化为成熟的髓系细胞群体。
       研究表明,采用相对低剂量的化疗药物能够有效清除MDSCs。在小鼠模型中,吉西他滨被证实能够清除MDSCs,而对T细胞的数量和功能无明显负面影响。这一效果不仅抑制了肿瘤的生长,还延长了实验动物的生存时间,并增强了它们对后续免疫治疗的敏感性[31]。同样地,顺铂和5-氟尿嘧啶也被发现能够选择性地清除MDSCs,而不影响其他免疫细胞,从而促进了CD8+ T细胞的免疫应答,增强了抗肿瘤效果[32]
       针对介导MDSC免疫抑制功能的相关介质进行靶向干预,可以有效抑制其免疫抑制作用。核因子E2相关因子2(nuclear factor erythroid  2-related factor 2,NRF2)作为一种重要的转录因子,在细胞抵抗自由基损伤方面扮演着核心角色。NRF2通过调控多种抗氧化酶的表达来清除ROS和NO,进而减轻细胞氧化应激。研究表明,通过合成三萜类化合物来上调NRF2的活性,已被证实能够减少MDSCs产生的ROS水平,并显著降低其在体内的免疫抑制活性[33]。此外,已有研究揭示了磷酸二酯酶-5(phosphodiesterase 5,PDE-5)抑制剂在调节免疫抑制相关酶方面的作用,发现其能够下调Arg1和iNOS的表达[34]。近期的临床报告进一步支持了这一发现,指出使用PDE-5抑制剂他达拉非治疗的头颈癌患者体内,循环中的MDSCs数量显著减少。同时,这些MDSCs中iNOS和Arg1的表达水平也较低,而T细胞的浸润则有所增加。二甲双胍通过抑制MDSCs中CD39和CD73的表达,从而抑制了卵巢癌患者的MDSCs的免疫抑制功能[35]在头颈部鳞状细胞癌患者的临床研究中,TLR8激动剂Motolimod能够显著抑制MDSCs的免疫抑制功[36]
       除了直接靶向MDSCs的抑制功能外,促进MDSCs分化为成熟的髓系细胞,如DC,同样是一种减少MDSCs的数量并改善免疫功能的有效策略。全反式维甲酸(all-trans retinoic acid,ATRA)已被证实能够促使MDSCs向DC分化,进而增强其免疫应答功能[37]。在肾细胞癌患者的治疗中,ATRA的应用显著降低了外周血中MDSCs的数量[38],显示了其在实际临床中的有效性。另一方面,信号转导与转录激活因子3(signal transducer and activator of transcription 3,STAT3)的靶向治疗能够促使MDSCs向DC分化[39]。舒尼替尼作为一种多靶点药物,通过抑制STAT3以及VEGF、c-Kit和M-CSF的信号传导,不仅降低了肾细胞癌患者体内的MDSCs水平,还显著改善了这些患者的抗肿瘤免疫应答[40]。肿瘤MDSCs高表达维生素D受体,维生素D处理能促进MDSCs向DC分化并且显著降低MDSCs的免疫抑制功能[41]

4  靶向 MDSCs 联合肿瘤免疫治疗的策略

       肿瘤免疫疗法,特别是ICIs和过继细胞疗法,近年来因其显著的疗效而备受瞩目。然而,在针对实体瘤的治疗中,这些方法的疗效仍显局限。鉴于此,越来越多的研究积极探索免疫疗法与其他治疗手段的结合策略,以期增强单一免疫疗法的效果。
       在肝细胞癌的治疗中,基于细胞因子诱导的杀伤细胞(cytokine-induced killer,CIK)的免疫疗法作为早期疾病的辅助治疗已展现出有效性,但在面对晚期肝癌时,其疗效却大打折扣。值得注意的是,CIK细胞治疗后观察到MDSCs数量的增加,这可能成为影响治疗效果的关键因素,同时也预示着MDSCs或可成为潜在的治疗靶点来提升整体疗效。近期一项关于CIK免疫抑制机制的研究揭示联合PDE5抑制剂的治疗策略,这一策略通过抑制Arg1和iNOS的活性,有效逆转了MDSCs的免疫抑制功能。同样,在体外实验中,应用PDE5抑制剂进行治疗显著抑制CD14+ HLA-DR-/low MDSCs的免疫抑制活性,并增强了CIK细胞对人类肝癌细胞的杀伤作用[42]。这一发现强有力地表明,针对MDSCs的靶向策略是提升CIK疗法在HCC患者中抗肿瘤效果的有效途径。TME中MDSCs的聚集被认为是CAR-T(chimeric antigen receptor-T)细胞在实体瘤治疗中表现不佳的主要原因之一。最新一代的聚腺苷二磷酸核糖聚合酶[Poly(ADP-ribose)polymerases,PAPR]抑制剂奥拉帕尼可以通过抑制MDSCs细胞的募集,从而增强CAR-T细胞在乳腺癌小鼠模型中的渗透性和存活率[43]当前研究已着手探索奥拉帕尼与靶向EGFRvIII的CAR-T细胞相结合的潜在治疗方案。CAR-T治疗过程中同时使用靶向FAP的CAR-T细胞,能够通过抑制MDSCs招募从而起到更强的抗肿瘤作用[44]
       尽管ICIs疗法在肿瘤免疫治疗领域取得了引人注目的成就,仍有相当一部分患者对ICIs无应答或发展出耐药性。此外,在面对免疫原性较弱或肿瘤免疫微环境被称为“冷”的肿瘤时,ICI疗法的有效率往往低于10%,这凸显了亟需开发增强免疫治疗效果新策略的紧迫性[45]。值得注意的是,免疫治疗无应答的患者群体中,往往伴随有高水平的循环MDSCs。这一现象不仅能够作为预测癌症免疫疗法反应性的生物标志物,还是导致ICI治疗耐药性的关键因素之一。MDSCs在TME中发挥着免疫抑制的作用,从而限制了免疫疗法的疗效。具体而言,MDSCs的水平已被用作预测患者对ICIs治疗反应的一个重要指标。研究表明,患者体内MDSCs的含量与接受抗PD-1或抗CTLA-4疗法后的临床疗效之间存在着显著的关联性[46-47]。值得注意的是,尽管PD-L1在多种癌症中广泛表达于多种细胞上,但髓系细胞上PD-L1的表达在抑制细胞毒性T淋巴细胞(cytotoxic T lymphocytes,CTL)功能方面展现出了比肿瘤细胞PD-L1表达更为有效的能力[48-49]。MDSCs可能通过PD-L1依赖及非依赖的双重机制来抑制CTL的活性。因此,将ICIs治疗与MDSCs清除策略相结合的治疗方案,已在多项临床前研究中得到探索,并取得了令人鼓舞的成效。具体而言,采用恩替司他和5-氮杂胞苷(这两种表观遗传调节药物可以抑制MDSCs的招募并促进MDSCs向巨噬细胞分化)与ICIs抗体(如抗PD-1和抗CTLA-4抗体)的联合疗法,成功促使侵袭性三阴性乳腺癌(triple negative breast cancer,TNBC)模型——4T1小鼠肿瘤实现完全消退,并显著抑制了肿瘤的转移进展。在肿瘤植入后的100 d观察期内,该联合治疗方案使小鼠的生存率提升至超过80%[50]。IL-6在肿瘤进展过程中扮演着关键角色,它显著促进MDSCs的积累和激活。尤为重要的是,IL-6水平的升高与癌症患者的疾病恶性程度及MDSCs的富集程度呈正相关[51]。鉴于此,已有多项临床前研究聚焦于通过阻断IL-6/IL-6R信号通路靶向癌症中的MDSCs。这些研究表明,IL-6的阻断或抗IL-6R单克隆抗体的应用能够逆转ICIs在多种肿瘤(如肝细胞癌、结直肠癌、黑色素瘤、三阴性乳腺癌及鳞状细胞癌)中的治疗抵抗现象。同时,这些干预措施还导致了MDSCs数量的显著减少、MDSCs抑制活性的降低,以及肿瘤浸润性CD8+ 效应T细胞的增加,从而增强了抗肿瘤免疫反应[52-53]。MDSCs的招募依赖于CXCR2和CCR2等趋化因子受体,在抗PD-1免疫治疗的同时用抗体阻断CXCR2和CCR2能够有效增强免疫治疗效果[54-55]

5  小结与展望

       近年来,肿瘤免疫疗法领域取得了令人瞩目的进展,为癌症患者带来了前所未有的治疗希望。然而,对于众多癌症患者而言,尽管初期可能对免疫疗法展现出良好的反应,但随后常因体内诱导的多种肿瘤免疫逃逸机制而面临反应受限、癌症复发等挑战[56]。已知MDSCs通过抑制抗肿瘤免疫应答,能够诱导宿主产生免疫耐受、支持癌症干细胞的存活,并促进肿瘤血管生成及血管成熟[57-58]。这些发现揭示了MDSCs靶向治疗方法不仅在免疫疗法中具有重要价值,而且对于多种癌症治疗策略而言,均展现出广泛而深远的意义。越来越多的研究证据表明,在癌症患者体内循环的MDSCs是预测疾病进程、肿瘤分期及转移潜能的预后生物标志物[59]。因此,MDSCs已被广泛认可为一个极具潜力的治疗靶点及癌症患者的预后评估标志物。尽管其重要性日益凸显,人源MDSCs的复杂性和高度异质性却为在TME中精确且统一地界定其表型带来了挑战。因此,深入研究MDSCs在不同类型肿瘤中的具体表型和特性,对于探索精确清除MDSCs的方法至关重要。尽管肿瘤MDSCs亚群之间在表型和功能机制上存在一定的共性,但细致识别并区分这些亚群之间的微妙差异,将为开发更为精准的个体化治疗方案提供重要依据。
       MDSCs研究领域目前仍面临着问题多于答案的现状。因此,首要任务是更全面地表征人类MDSCs,并深入探究MDSCs靶向策略是否具备临床转化的实际意义。当前,我们对正在进行的临床前试验结果尚缺乏全面把握,这些试验旨在抑制MDSCs的免疫抑制活性、阻断其募集与扩增,以及诱导MDSCs分化为成熟的髓系细胞。通过重编程肿瘤中的MDSCs,并结合新兴的免疫疗法(如免疫检查点阻断疗法ICI或细胞免疫疗法ACT),展现出了提升抗肿瘤免疫能力的巨大潜力。然而,在推进这些治疗策略的同时,我们必须保持高度的警惕性,严格评估并有效管理可能伴随出现的各种不良事件,以确保治疗的安全性和有效性。激发抗肿瘤免疫反应,同时有效遏制抑制性免疫反应的激活,是设计抗肿瘤免疫疗法的理想蓝图。尽管全身性清除抑制免疫调节细胞(如Treg细胞)展现出巨大潜力,但其伴随的显著免疫相关不良反应不容忽视[60]。因此,当前的主要挑战在于如何在肿瘤局部或其邻近区域内实现精细的免疫调控,旨在增强抗肿瘤免疫效能的同时,最大限度减少对正常免疫系统的非特异性干扰。在此背景下,制定针对MDSCs特定亚群的治疗策略显得尤为重要,这是提高肿瘤治疗效率与安全性的关键一环。随着癌症免疫疗法转化研究的深入,深化对MDSCs靶向策略的理解与应用正逐步成为推动该领域向前发展的强大动力。通过精准调控MDSCs,我们有望实现抗肿瘤免疫反应的精准激活,为癌症患者量身打造更加个性化和高效的治疗方案,开启癌症免疫治疗的新篇章。
1、%E2%80%83%20ZHANG%E2%80%83Y%EF%BC%8CZHANG%E2%80%83%20Z.%E2%80%83%20The%E2%80%83%20history%E2%80%83%20and%E2%80%83%20advances%E2%80%83%0Ain%E2%80%83cancer%E2%80%83immunotherapy%EF%BC%9Aunde%20rstanding%E2%80%83%20the%E2%80%83%0Acharacteristics%E2%80%83%20of%E2%80%83tumor-infiltrating%E2%80%83immune%E2%80%83%20cells%E2%80%83%0Aand%E2%80%83their%E2%80%83therapeutic%E2%80%83implications%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECell%E2%80%83Mol%E2%80%83%0AImmunol%EF%BC%8C2020%EF%BC%8C17%EF%BC%888%EF%BC%89%EF%BC%9A807-821%EF%BC%8E%E2%80%83%20ZHANG%E2%80%83Y%EF%BC%8CZHANG%E2%80%83%20Z.%E2%80%83%20The%E2%80%83%20history%E2%80%83%20and%E2%80%83%20advances%E2%80%83%0Ain%E2%80%83cancer%E2%80%83immunotherapy%EF%BC%9Aunde%20rstanding%E2%80%83%20the%E2%80%83%0Acharacteristics%E2%80%83%20of%E2%80%83tumor-infiltrating%E2%80%83immune%E2%80%83%20cells%E2%80%83%0Aand%E2%80%83their%E2%80%83therapeutic%E2%80%83implications%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECell%E2%80%83Mol%E2%80%83%0AImmunol%EF%BC%8C2020%EF%BC%8C17%EF%BC%888%EF%BC%89%EF%BC%9A807-821%EF%BC%8E
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3、%E2%80%83%20SIU%E2%80%83L%E2%80%83L%EF%BC%8CIVY%E2%80%83S%E2%80%83P%EF%BC%8CDIXON%E2%80%83E%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EChallenges%E2%80%83%0Aand%E2%80%83Opportunities%E2%80%83in%E2%80%83Adapting%E2%80%83Clinical%E2%80%83Trial%E2%80%83Design%E2%80%83for%E2%80%83%0AImmunotherapies%EF%BC%BBJ%EF%BC%BD%EF%BC%8EClin%E2%80%83Cancer%E2%80%83Res%EF%BC%8C2017%EF%BC%8C23%0A%EF%BC%8817%EF%BC%89%EF%BC%9A4950-4958%EF%BC%8E%E2%80%83%20SIU%E2%80%83L%E2%80%83L%EF%BC%8CIVY%E2%80%83S%E2%80%83P%EF%BC%8CDIXON%E2%80%83E%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EChallenges%E2%80%83%0Aand%E2%80%83Opportunities%E2%80%83in%E2%80%83Adapting%E2%80%83Clinical%E2%80%83Trial%E2%80%83Design%E2%80%83for%E2%80%83%0AImmunotherapies%EF%BC%BBJ%EF%BC%BD%EF%BC%8EClin%E2%80%83Cancer%E2%80%83Res%EF%BC%8C2017%EF%BC%8C23%0A%EF%BC%8817%EF%BC%89%EF%BC%9A4950-4958%EF%BC%8E
4、%E2%80%83%20BEATTY%E2%80%83G%E2%80%83L%EF%BC%8CGLADNEY%E2%80%83W%E2%80%83L%EF%BC%8EImmune%E2%80%83%20escape%E2%80%83%0Amechanisms%E2%80%83as%E2%80%83a%E2%80%83guide%E2%80%83for%E2%80%83cancer%E2%80%83immunotherapy%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0AClin%E2%80%83Cancer%E2%80%83Res%EF%BC%8C2015%EF%BC%8C21%EF%BC%884%EF%BC%89%EF%BC%9A687-692%EF%BC%8E%E2%80%83%20BEATTY%E2%80%83G%E2%80%83L%EF%BC%8CGLADNEY%E2%80%83W%E2%80%83L%EF%BC%8EImmune%E2%80%83%20escape%E2%80%83%0Amechanisms%E2%80%83as%E2%80%83a%E2%80%83guide%E2%80%83for%E2%80%83cancer%E2%80%83immunotherapy%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0AClin%E2%80%83Cancer%E2%80%83Res%EF%BC%8C2015%EF%BC%8C21%EF%BC%884%EF%BC%89%EF%BC%9A687-692%EF%BC%8E
5、VINAY%E2%80%83D%E2%80%83S%EF%BC%8CRYAN%E2%80%83E%E2%80%83P%EF%BC%8CPAWELEC%E2%80%83G%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0AImmune%E2%80%83evasion%E2%80%83in%E2%80%83cancer%EF%BC%9AMechanistic%E2%80%83%20basis%E2%80%83%20and%E2%80%83%0Atherapeutic%E2%80%83strategies%EF%BC%BBJ%EF%BC%BD%EF%BC%8ESemin%E2%80%83Cancer%E2%80%83Biol%EF%BC%8C%0A2015%EF%BC%8C35%E2%80%83Suppl%EF%BC%9AS185-S98%EF%BC%8EVINAY%E2%80%83D%E2%80%83S%EF%BC%8CRYAN%E2%80%83E%E2%80%83P%EF%BC%8CPAWELEC%E2%80%83G%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0AImmune%E2%80%83evasion%E2%80%83in%E2%80%83cancer%EF%BC%9AMechanistic%E2%80%83%20basis%E2%80%83%20and%E2%80%83%0Atherapeutic%E2%80%83strategies%EF%BC%BBJ%EF%BC%BD%EF%BC%8ESemin%E2%80%83Cancer%E2%80%83Biol%EF%BC%8C%0A2015%EF%BC%8C35%E2%80%83Suppl%EF%BC%9AS185-S98%EF%BC%8E
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8、WU%E2%80%83Y%EF%BC%8CYI%E2%80%83M%EF%BC%8CNIU%E2%80%83M%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid-derived%E2%80%83%0Asuppressor%E2%80%83cells%EF%BC%9Aan%E2%80%83%20emerging%E2%80%83target%E2%80%83for%E2%80%83%20anticancer%E2%80%83%0Aimmunotherapy%EF%BC%BBJ%EF%BC%BD%EF%BC%8EMol%E2%80%83Cancer%EF%BC%8C2022%EF%BC%8C21%0A%EF%BC%881%EF%BC%89%EF%BC%9A184%EF%BC%8EWU%E2%80%83Y%EF%BC%8CYI%E2%80%83M%EF%BC%8CNIU%E2%80%83M%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid-derived%E2%80%83%0Asuppressor%E2%80%83cells%EF%BC%9Aan%E2%80%83%20emerging%E2%80%83target%E2%80%83for%E2%80%83%20anticancer%E2%80%83%0Aimmunotherapy%EF%BC%BBJ%EF%BC%BD%EF%BC%8EMol%E2%80%83Cancer%EF%BC%8C2022%EF%BC%8C21%0A%EF%BC%881%EF%BC%89%EF%BC%9A184%EF%BC%8E
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15、YOUN%E2%80%83J%E2%80%83I%EF%BC%8CCOLLAZO%E2%80%83M%EF%BC%8CSHALOVA%E2%80%83I%E2%80%83N%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ACharacterization%E2%80%83of%E2%80%83the%E2%80%83nature%E2%80%83of%E2%80%83granulocytic%E2%80%83myeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83in%E2%80%83tumor-bearing%E2%80%83mice%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83%0ALeukoc%E2%80%83Biol%EF%BC%8C2012%EF%BC%8C91%EF%BC%881%EF%BC%89%EF%BC%9A167-181%EF%BC%8EYOUN%E2%80%83J%E2%80%83I%EF%BC%8CCOLLAZO%E2%80%83M%EF%BC%8CSHALOVA%E2%80%83I%E2%80%83N%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ACharacterization%E2%80%83of%E2%80%83the%E2%80%83nature%E2%80%83of%E2%80%83granulocytic%E2%80%83myeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83in%E2%80%83tumor-bearing%E2%80%83mice%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83%0ALeukoc%E2%80%83Biol%EF%BC%8C2012%EF%BC%8C91%EF%BC%881%EF%BC%89%EF%BC%9A167-181%EF%BC%8E
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23、SRIVASTAVA%E2%80%83M%E2%80%83K%EF%BC%8CSINHA%E2%80%83P%EF%BC%8CCLEMENTS%E2%80%83V%E2%80%83K%EF%BC%8C%0Aet%E2%80%83al%EF%BC%8EMyeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83inhibit%E2%80%83T-cell%E2%80%83%0Aactivation%E2%80%83by%E2%80%83depleting%E2%80%83cystine%E2%80%83and%E2%80%83cysteine%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0ACancer%E2%80%83Res%EF%BC%8C2010%EF%BC%8C70%EF%BC%881%EF%BC%89%EF%BC%9A68-77%EF%BC%8ESRIVASTAVA%E2%80%83M%E2%80%83K%EF%BC%8CSINHA%E2%80%83P%EF%BC%8CCLEMENTS%E2%80%83V%E2%80%83K%EF%BC%8C%0Aet%E2%80%83al%EF%BC%8EMyeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83inhibit%E2%80%83T-cell%E2%80%83%0Aactivation%E2%80%83by%E2%80%83depleting%E2%80%83cystine%E2%80%83and%E2%80%83cysteine%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0ACancer%E2%80%83Res%EF%BC%8C2010%EF%BC%8C70%EF%BC%881%EF%BC%89%EF%BC%9A68-77%EF%BC%8E
24、%E2%80%83%20PLATTEN%E2%80%83M%EF%BC%8CWICK%E2%80%83W%EF%BC%8Cvan%E2%80%83DEN%E2%80%83EYNDE%E2%80%83B%E2%80%83J%EF%BC%8E%0ATryptophan%E2%80%83catabolism%E2%80%83in%E2%80%83cancer%EF%BC%9Abeyond%E2%80%83%20IDO%E2%80%83%20and%E2%80%83%0Atryptophan%E2%80%83depletion%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83Res%EF%BC%8C2012%EF%BC%8C72%0A%EF%BC%8821%EF%BC%89%EF%BC%9A5435-5440%EF%BC%8E%E2%80%83%20PLATTEN%E2%80%83M%EF%BC%8CWICK%E2%80%83W%EF%BC%8Cvan%E2%80%83DEN%E2%80%83EYNDE%E2%80%83B%E2%80%83J%EF%BC%8E%0ATryptophan%E2%80%83catabolism%E2%80%83in%E2%80%83cancer%EF%BC%9Abeyond%E2%80%83%20IDO%E2%80%83%20and%E2%80%83%0Atryptophan%E2%80%83depletion%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83Res%EF%BC%8C2012%EF%BC%8C72%0A%EF%BC%8821%EF%BC%89%EF%BC%9A5435-5440%EF%BC%8E
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26、%E2%80%83%20BRONTE%E2%80%83V%EF%BC%8CBRANDAU%E2%80%83S%EF%BC%8CCHEN%E2%80%83S%E2%80%83H%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ARecommendations%E2%80%83for%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cell%E2%80%83%0Anomenclature%E2%80%83and%E2%80%83characterization%E2%80%83standards%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0ANat%E2%80%83Commun%EF%BC%8C2016%EF%BC%887%EF%BC%89%EF%BC%9A12150%EF%BC%8E%E2%80%83%20BRONTE%E2%80%83V%EF%BC%8CBRANDAU%E2%80%83S%EF%BC%8CCHEN%E2%80%83S%E2%80%83H%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ARecommendations%E2%80%83for%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cell%E2%80%83%0Anomenclature%E2%80%83and%E2%80%83characterization%E2%80%83standards%EF%BC%BBJ%EF%BC%BD%EF%BC%8E%0ANat%E2%80%83Commun%EF%BC%8C2016%EF%BC%887%EF%BC%89%EF%BC%9A12150%EF%BC%8E
27、%E2%80%83%20FENG%E2%80%83S%EF%BC%8CCHENG%E2%80%83X%EF%BC%8CZHANG%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83inhibit%E2%80%83T%E2%80%83cell%E2%80%83activation%E2%80%83through%E2%80%83%0Anitrating%E2%80%83LCK%E2%80%83in%E2%80%83mouse%E2%80%83cancers%EF%BC%BBJ%EF%BC%BD%EF%BC%8EProc%E2%80%83Natl%E2%80%83Acad%E2%80%83%0ASci%E2%80%83U%E2%80%83S%E2%80%83A%EF%BC%8C2018%EF%BC%8C115%EF%BC%8840%EF%BC%89%EF%BC%9A10094-10099%EF%BC%8E%E2%80%83%20FENG%E2%80%83S%EF%BC%8CCHENG%E2%80%83X%EF%BC%8CZHANG%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83inhibit%E2%80%83T%E2%80%83cell%E2%80%83activation%E2%80%83through%E2%80%83%0Anitrating%E2%80%83LCK%E2%80%83in%E2%80%83mouse%E2%80%83cancers%EF%BC%BBJ%EF%BC%BD%EF%BC%8EProc%E2%80%83Natl%E2%80%83Acad%E2%80%83%0ASci%E2%80%83U%E2%80%83S%E2%80%83A%EF%BC%8C2018%EF%BC%8C115%EF%BC%8840%EF%BC%89%EF%BC%9A10094-10099%EF%BC%8E
28、SINHA%E2%80%83P%EF%BC%8CCLEMENTS%E2%80%83V%E2%80%83K%EF%BC%8CBUNT%E2%80%83S%E2%80%83K%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ACross-talk%E2%80%83between%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83%0Aand%E2%80%83%20macrophages%E2%80%83%20subverts%E2%80%83tumor%E2%80%83immunity%E2%80%83toward%E2%80%83%0Aa%E2%80%83type%E2%80%832%E2%80%83response%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83Immunol%EF%BC%8C2007%EF%BC%8C179%0A%EF%BC%882%EF%BC%89%EF%BC%9A977-983%EF%BC%8ESINHA%E2%80%83P%EF%BC%8CCLEMENTS%E2%80%83V%E2%80%83K%EF%BC%8CBUNT%E2%80%83S%E2%80%83K%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0ACross-talk%E2%80%83between%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83%0Aand%E2%80%83%20macrophages%E2%80%83%20subverts%E2%80%83tumor%E2%80%83immunity%E2%80%83toward%E2%80%83%0Aa%E2%80%83type%E2%80%832%E2%80%83response%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83Immunol%EF%BC%8C2007%EF%BC%8C179%0A%EF%BC%882%EF%BC%89%EF%BC%9A977-983%EF%BC%8E
29、LI%E2%80%83J%EF%BC%8CWANG%E2%80%83L%EF%BC%8CCHEN%E2%80%83X%EF%BC%8Cet%E2%80%83al%EF%BC%8ECD39%2FCD73%E2%80%83%0Aupregulation%E2%80%83on%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83via%E2%80%83%0ATGF-beta-mTOR-HIF-1%E2%80%83%20signaling%E2%80%83in%E2%80%83%20patients%E2%80%83with%E2%80%83%0Anon-small%E2%80%83cell%E2%80%83lung%E2%80%83cancer%EF%BC%BBJ%EF%BC%BD%EF%BC%8EOncoimmunology%EF%BC%8C%0A2017%EF%BC%8C6%EF%BC%886%EF%BC%89%EF%BC%9Ae1320011%EF%BC%8ELI%E2%80%83J%EF%BC%8CWANG%E2%80%83L%EF%BC%8CCHEN%E2%80%83X%EF%BC%8Cet%E2%80%83al%EF%BC%8ECD39%2FCD73%E2%80%83%0Aupregulation%E2%80%83on%E2%80%83myeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83via%E2%80%83%0ATGF-beta-mTOR-HIF-1%E2%80%83%20signaling%E2%80%83in%E2%80%83%20patients%E2%80%83with%E2%80%83%0Anon-small%E2%80%83cell%E2%80%83lung%E2%80%83cancer%EF%BC%BBJ%EF%BC%BD%EF%BC%8EOncoimmunology%EF%BC%8C%0A2017%EF%BC%8C6%EF%BC%886%EF%BC%89%EF%BC%9Ae1320011%EF%BC%8E
30、HAN%E2%80%83B%EF%BC%8CMAO%E2%80%83F%E2%80%83Y%EF%BC%8CZHAO%E2%80%83Y%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EAltered%E2%80%83%0ANKp30%EF%BC%8CNKp46%EF%BC%8CNKG2D%EF%BC%8Cand%E2%80%83DNAM-1%E2%80%83Expression%E2%80%83%0Aon%E2%80%83%20circulating%E2%80%83%20NK%E2%80%83%20cells%E2%80%83%20is%E2%80%83%20associated%E2%80%83%20with%E2%80%83%20tumor%E2%80%83%0Aprogression%E2%80%83in%E2%80%83human%E2%80%83gastric%E2%80%83cancer%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83Immunol%E2%80%83%0ARes%EF%BC%8C2018%EF%BC%882018%EF%BC%89%EF%BC%9A6248590%EF%BC%8EHAN%E2%80%83B%EF%BC%8CMAO%E2%80%83F%E2%80%83Y%EF%BC%8CZHAO%E2%80%83Y%E2%80%83L%EF%BC%8Cet%E2%80%83al%EF%BC%8EAltered%E2%80%83%0ANKp30%EF%BC%8CNKp46%EF%BC%8CNKG2D%EF%BC%8Cand%E2%80%83DNAM-1%E2%80%83Expression%E2%80%83%0Aon%E2%80%83%20circulating%E2%80%83%20NK%E2%80%83%20cells%E2%80%83%20is%E2%80%83%20associated%E2%80%83%20with%E2%80%83%20tumor%E2%80%83%0Aprogression%E2%80%83in%E2%80%83human%E2%80%83gastric%E2%80%83cancer%EF%BC%BBJ%EF%BC%BD%EF%BC%8EJ%E2%80%83Immunol%E2%80%83%0ARes%EF%BC%8C2018%EF%BC%882018%EF%BC%89%EF%BC%9A6248590%EF%BC%8E
31、GUJAR%E2%80%83S%E2%80%83A%EF%BC%8CCLEMENTS%E2%80%83D%EF%BC%8CDIELSCHNEIDER%E2%80%83R%EF%BC%8C%0Aet%E2%80%83al%EF%BC%8EGemcitabine%E2%80%83enhances%E2%80%83the%E2%80%83efficacy%E2%80%83of%E2%80%83reovirus%02based%E2%80%83oncotherapy%E2%80%83through%E2%80%83anti-tumour%E2%80%83immunological%E2%80%83%0Amechanisms%EF%BC%BBJ%EF%BC%BD%EF%BC%8EBr%E2%80%83J%E2%80%83Cancer%EF%BC%8C2014%EF%BC%8C110%EF%BC%881%EF%BC%89%EF%BC%9A%0A83-93%EF%BC%8EGUJAR%E2%80%83S%E2%80%83A%EF%BC%8CCLEMENTS%E2%80%83D%EF%BC%8CDIELSCHNEIDER%E2%80%83R%EF%BC%8C%0Aet%E2%80%83al%EF%BC%8EGemcitabine%E2%80%83enhances%E2%80%83the%E2%80%83efficacy%E2%80%83of%E2%80%83reovirus%02based%E2%80%83oncotherapy%E2%80%83through%E2%80%83anti-tumour%E2%80%83immunological%E2%80%83%0Amechanisms%EF%BC%BBJ%EF%BC%BD%EF%BC%8EBr%E2%80%83J%E2%80%83Cancer%EF%BC%8C2014%EF%BC%8C110%EF%BC%881%EF%BC%89%EF%BC%9A%0A83-93%EF%BC%8E
32、%E2%80%83%20VINCENT%E2%80%83J%EF%BC%8CMIGNOT%E2%80%83G%EF%BC%8CCHALMIN%E2%80%83F%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0A5-Fluorouracil%E2%80%83%20selectively%E2%80%83%20kills%E2%80%83tumor-associated%E2%80%83%0Amyeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83resulting%E2%80%83in%E2%80%83enhanced%E2%80%83%0AT%E2%80%83cell-dependent%E2%80%83antitumor%E2%80%83immunity%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83%0ARes%EF%BC%8C2010%EF%BC%8C70%EF%BC%888%EF%BC%89%EF%BC%9A3052-3061%EF%BC%8E%E2%80%83%20VINCENT%E2%80%83J%EF%BC%8CMIGNOT%E2%80%83G%EF%BC%8CCHALMIN%E2%80%83F%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0A5-Fluorouracil%E2%80%83%20selectively%E2%80%83%20kills%E2%80%83tumor-associated%E2%80%83%0Amyeloid-derived%E2%80%83suppressor%E2%80%83cells%E2%80%83resulting%E2%80%83in%E2%80%83enhanced%E2%80%83%0AT%E2%80%83cell-dependent%E2%80%83antitumor%E2%80%83immunity%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83%0ARes%EF%BC%8C2010%EF%BC%8C70%EF%BC%888%EF%BC%89%EF%BC%9A3052-3061%EF%BC%8E
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56、%E2%80%83%20GORDY%E2%80%83J%E2%80%83T%EF%BC%8CSANDHU%E2%80%83A%E2%80%83K%EF%BC%8CFESSLER%E2%80%83K%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0AIFNalpha%E2%80%83and%E2%80%835-Aza-2%E2%80%99-deoxycytidine%E2%80%83%20combined%E2%80%83%0Awith%E2%80%83a%E2%80%83dendritic-cell%E2%80%83targeting%E2%80%83DNA%E2%80%83vaccine%E2%80%83alter%E2%80%83tumor%E2%80%83%0Aimmune%E2%80%83cell%E2%80%83infiltration%E2%80%83in%E2%80%83the%E2%80%83B16F10%E2%80%83melanoma%E2%80%83model%0A%EF%BC%BBJ%EF%BC%BD%EF%BC%8EFront%E2%80%83Immunol%EF%BC%8C2022%EF%BC%8813%EF%BC%89%EF%BC%9A1074644%EF%BC%8E%E2%80%83%20GORDY%E2%80%83J%E2%80%83T%EF%BC%8CSANDHU%E2%80%83A%E2%80%83K%EF%BC%8CFESSLER%E2%80%83K%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0AIFNalpha%E2%80%83and%E2%80%835-Aza-2%E2%80%99-deoxycytidine%E2%80%83%20combined%E2%80%83%0Awith%E2%80%83a%E2%80%83dendritic-cell%E2%80%83targeting%E2%80%83DNA%E2%80%83vaccine%E2%80%83alter%E2%80%83tumor%E2%80%83%0Aimmune%E2%80%83cell%E2%80%83infiltration%E2%80%83in%E2%80%83the%E2%80%83B16F10%E2%80%83melanoma%E2%80%83model%0A%EF%BC%BBJ%EF%BC%BD%EF%BC%8EFront%E2%80%83Immunol%EF%BC%8C2022%EF%BC%8813%EF%BC%89%EF%BC%9A1074644%EF%BC%8E
57、%E2%80%83%20PENG%E2%80%83D%EF%BC%8CTANIKAWA%E2%80%83T%EF%BC%8CLI%E2%80%83W%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83endow%E2%80%83stem-like%E2%80%83qualities%E2%80%83to%E2%80%83%0Abreast%E2%80%83cancer%E2%80%83cells%E2%80%83through%E2%80%83IL6%2FSTAT3%E2%80%83and%E2%80%83NO%2FNOTCH%E2%80%83%0Across-talk%E2%80%83signaling%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83Res%EF%BC%8C2016%EF%BC%8C76%0A%EF%BC%8811%EF%BC%89%EF%BC%9A3156-3165%EF%BC%8E%E2%80%83%20PENG%E2%80%83D%EF%BC%8CTANIKAWA%E2%80%83T%EF%BC%8CLI%E2%80%83W%EF%BC%8Cet%E2%80%83al%EF%BC%8EMyeloid%02derived%E2%80%83suppressor%E2%80%83cells%E2%80%83endow%E2%80%83stem-like%E2%80%83qualities%E2%80%83to%E2%80%83%0Abreast%E2%80%83cancer%E2%80%83cells%E2%80%83through%E2%80%83IL6%2FSTAT3%E2%80%83and%E2%80%83NO%2FNOTCH%E2%80%83%0Across-talk%E2%80%83signaling%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECancer%E2%80%83Res%EF%BC%8C2016%EF%BC%8C76%0A%EF%BC%8811%EF%BC%89%EF%BC%9A3156-3165%EF%BC%8E
58、WAN%E2%80%83S%EF%BC%8CZHAO%E2%80%83E%EF%BC%8CKRYCZEK%E2%80%83I%EF%BC%8Cet%E2%80%83al%EF%BC%8ETumor%02associated%E2%80%83macrophages%E2%80%83produce%E2%80%83interleukin%E2%80%836%E2%80%83and%E2%80%83signal%E2%80%83%0Avia%E2%80%83STAT3%E2%80%83to%E2%80%83promote%E2%80%83expansion%E2%80%83of%E2%80%83human%E2%80%83hepatocellular%E2%80%83%0Acarcinoma%E2%80%83stem%E2%80%83cells%EF%BC%BBJ%EF%BC%BD%EF%BC%8EGastroenterology%EF%BC%8C2014%EF%BC%8C%0A147%EF%BC%886%EF%BC%89%EF%BC%9A1393-1404%EF%BC%8EWAN%E2%80%83S%EF%BC%8CZHAO%E2%80%83E%EF%BC%8CKRYCZEK%E2%80%83I%EF%BC%8Cet%E2%80%83al%EF%BC%8ETumor%02associated%E2%80%83macrophages%E2%80%83produce%E2%80%83interleukin%E2%80%836%E2%80%83and%E2%80%83signal%E2%80%83%0Avia%E2%80%83STAT3%E2%80%83to%E2%80%83promote%E2%80%83expansion%E2%80%83of%E2%80%83human%E2%80%83hepatocellular%E2%80%83%0Acarcinoma%E2%80%83stem%E2%80%83cells%EF%BC%BBJ%EF%BC%BD%EF%BC%8EGastroenterology%EF%BC%8C2014%EF%BC%8C%0A147%EF%BC%886%EF%BC%89%EF%BC%9A1393-1404%EF%BC%8E
59、WANG%E2%80%83P%E2%80%83F%EF%BC%8CSONG%E2%80%83S%E2%80%83Y%EF%BC%8CWANG%E2%80%83T%E2%80%83J%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0APrognostic%E2%80%83%20role%E2%80%83of%E2%80%83pretreatment%E2%80%83circulating%E2%80%83MDSCs%E2%80%83in%E2%80%83%0Apatients%E2%80%83with%E2%80%83solid%E2%80%83malignancies%EF%BC%9AA%E2%80%83meta-analysis%E2%80%83%0Aof%E2%80%8340%E2%80%83studies%EF%BC%BBJ%EF%BC%BD%EF%BC%8EOncoimmunology%EF%BC%8C2018%EF%BC%8C7%0A%EF%BC%8810%EF%BC%89%EF%BC%9Ae1494113%EF%BC%8EWANG%E2%80%83P%E2%80%83F%EF%BC%8CSONG%E2%80%83S%E2%80%83Y%EF%BC%8CWANG%E2%80%83T%E2%80%83J%EF%BC%8Cet%E2%80%83al%EF%BC%8E%0APrognostic%E2%80%83%20role%E2%80%83of%E2%80%83pretreatment%E2%80%83circulating%E2%80%83MDSCs%E2%80%83in%E2%80%83%0Apatients%E2%80%83with%E2%80%83solid%E2%80%83malignancies%EF%BC%9AA%E2%80%83meta-analysis%E2%80%83%0Aof%E2%80%8340%E2%80%83studies%EF%BC%BBJ%EF%BC%BD%EF%BC%8EOncoimmunology%EF%BC%8C2018%EF%BC%8C7%0A%EF%BC%8810%EF%BC%89%EF%BC%9Ae1494113%EF%BC%8E
60、%E2%80%83NAKAMURA%E2%80%83K%20%EF%BC%8C%20SMYTH%E2%80%83M%E2%80%83J%20%EF%BC%8E%20M%20y%20e%20l%20o%20i%20d%E2%80%83%0Aimmunosuppression%E2%80%83and%E2%80%83immune%E2%80%83checkpoints%E2%80%83in%E2%80%83the%E2%80%83%0Atumor%E2%80%83microenvironment%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECell%E2%80%83Mol%E2%80%83Immunol%EF%BC%8C%0A2020%EF%BC%8C17%EF%BC%881%EF%BC%89%EF%BC%9A1-12%EF%BC%8E%E2%80%83NAKAMURA%E2%80%83K%20%EF%BC%8C%20SMYTH%E2%80%83M%E2%80%83J%20%EF%BC%8E%20M%20y%20e%20l%20o%20i%20d%E2%80%83%0Aimmunosuppression%E2%80%83and%E2%80%83immune%E2%80%83checkpoints%E2%80%83in%E2%80%83the%E2%80%83%0Atumor%E2%80%83microenvironment%EF%BC%BBJ%EF%BC%BD%EF%BC%8ECell%E2%80%83Mol%E2%80%83Immunol%EF%BC%8C%0A2020%EF%BC%8C17%EF%BC%881%EF%BC%89%EF%BC%9A1-12%EF%BC%8E
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