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Immune niche of GSC. Via releasing macrophage colony-stimulating factor (M-CSF) and TGF-β, GSC could promote M2-polarization of TAM; by secreting hypoxia-related galectin-3, GSCs suppress proliferation of effector T cells; hypoxia enhances the PD-L1 level of activated T cells and induces interleukin-6-activated STAT3 to impede cytotoxity of CTLs (cytotoxic T lymphocytes). The above described processes all contribute to immune suppression and decreased survival of GBM patients.
