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Modulation of macrophage metabolism as an emerging immunotherapy strategy for cancer
Corey Dussold, … , Amy B. Heimberger, Jason Miska
Corey Dussold, … , Amy B. Heimberger, Jason Miska
Published January 16, 2024
Citation Information: J Clin Invest. 2024;134(2):e175445. https://doi.org/10.1172/JCI175445.
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Review

Modulation of macrophage metabolism as an emerging immunotherapy strategy for cancer

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Abstract

Immunometabolism is a burgeoning field of research that investigates how immune cells harness nutrients to drive their growth and functions. Myeloid cells play a pivotal role in tumor biology, yet their metabolic influence on tumor growth and antitumor immune responses remains inadequately understood. This Review explores the metabolic landscape of tumor-associated macrophages, including the immunoregulatory roles of glucose, fatty acids, glutamine, and arginine, alongside the tools used to perturb their metabolism to promote antitumor immunity. The confounding role of metabolic inhibitors on our interpretation of myeloid metabolic phenotypes will also be discussed. A binary metabolic schema is currently used to describe macrophage immunological phenotypes, characterizing inflammatory M1 phenotypes, as supported by glycolysis, and immunosuppressive M2 phenotypes, as supported by oxidative phosphorylation. However, this classification likely underestimates the variety of states in vivo. Understanding these nuances will be critical when developing interventional metabolic strategies. Future research should focus on refining drug specificity and targeted delivery methods to maximize therapeutic efficacy.

Authors

Corey Dussold, Kaylee Zilinger, Jillyn Turunen, Amy B. Heimberger, Jason Miska

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Figure 2

Glycolysis, oxidative phosphorylation, and fatty acid oxidation in immunosuppressive myeloid cells and therapeutic strategies.

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Glycolysis, oxidative phosphorylation, and fatty acid oxidation in immun...
2-Deoxyglucose (2-DG) and the BBB permeable prodrug (WP1122) are glucose analogs that have been shown to prevent tumor growth and perturb TAM. shRNA targeting phosphofructokinase 1 (PFK1) has been shown to prevent immunosuppressive macrophages. UK5099, inhibits the mitochondrial pyruvate carrier (MPC) and can prevent immunosuppressive macrophage phenotypes induced by lactate metabolism in TAM. Etomoxir, while historically thought to be a fatty acid oxidation inhibitor (FAO), has off-target effects responsible for inhibiting alternative activation. Metformin, which potently inhibits immunosuppressive macrophage activation, while originally thought to be an AMPK activator, can also inhibit complex 1 of the electron transport chain (ETC). Tamoxifen has shown anti-ETC activities that may underlie its suppression of immunosuppressive macrophage activation. ACLY, ATP-citrate lyase.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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