Macrophages are versatile and heterogeneous innate immune cells undertaking central functions in balancing immune responses and tissue repair to maintain homeostasis. This plasticity, once co-opted by malignant outgrowth, orchestrates manifold reciprocal interactions within the tumor microenvironment, fueling the evolution of the cancer ecosystem. Here, we review the multilayered sources of influence that jointly underpin and longitudinally shape tumor-associated macrophage (TAM) phenotypic states in solid neoplasms. We discuss how, in response to these signals, TAMs steer tumor evolution in the context of natural selection, biological dispersion, and treatment resistance. A number of research frontiers to be tackled are laid down in this review to therapeutically exploit the complex roles of TAMs in cancer. Building upon knowledge obtained from currently applied TAM-targeting strategies and using next generation technologies, we propose conceptual advances and novel therapeutic avenues to rewire TAM multifaceted regulation of the co-evolving cancer ecosystem.
巨噬细胞是具有多面性与异质性的先天免疫细胞,在平衡免疫反应和组织修复以维持稳态中发挥核心功能。这种可塑性一旦被恶性增殖所利用,便能在肿瘤微环境中协调多种双向互作,推动癌症生态系统的演化。本文综述了共同支撑并纵向塑造实体瘤中肿瘤相关巨噬细胞表型状态的多层次影响因素,探讨了TAM如何响应这些信号,在自然选择、生物扩散和治疗抵抗的背景下引导肿瘤进化。文章提出多个亟待攻克的研究前沿,旨在从治疗层面开发利用TAM在癌症中的复杂功能。基于现有TAM靶向策略所获知识及下一代技术,我们提出了重构TAM对协同演化癌症生态系统多维度调控的概念进展与新型治疗路径。
Macrophages at the interface of the co-evolving cancer ecosystem