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. 2018 Dec 5;8:578. doi: 10.3389/fonc.2018.00578

Figure 1.

Figure 1

Normal Inflammation vs. Immunosuppression Mechanisms. Antigen presenting cells (APCs) phagocytose tumor antigens and present to cytotoxic T cells as well as naïve CD4+ cells. Via coactivation signals, the APCS activate the cytotoxic T cells (A) and skew helper T cells to a proinflammatory Th1 lineage (B). The activated cytotoxic T cells then recognize and attack malignant cells (C). T regulatory cells, M2 macrophages, and MDSCs are major mediators of immune suppression. M0 macrophages may be skewed toward a pro-inflammatory M1 phenotype by IFN-γ (D), which directly phagocytose target cells and release proinflammatory cytokines. (E) Glioblastoma cells also signal M0 macrophages to skew toward an M2 phenotype which release immunosuppressive cytokines. Immune checkpoints induce anergy and apoptosis of CD8+ cytotoxic T cells (F) and CD4+ cells.