Table 1.

Role of tumor-derived exosomes (TEX) in immunosuppression.

Immune Cells	TEX Effects	Non-TEX Effects	References
Natural killer (NK) cells	Suppressed cytolytic activity. Downregulation of NKG2D and impaired cell cytotoxic function.	Activating NKG2D, NKP30, NKP46, and NKG2C receptors inducing NK cell cytotoxicity	[41,42]
Dendritic cells (DC)	Suppressed differentiation, maturation, and activity. Suppress migration through chemokine receptor expression inhibition.		[43,44,45]
Myeloid-derived suppressor cells (MDSC)	Increase the progression of MDSCs, expediting their activation, aiding expansion, and increasing the immunosuppressive role.		[46]
Regulatory T-cells (Treg)	Increased proliferation and expansion. Induced immune suppression by supporting extension of CD4(+)CD25(+)FOXP3(+)T regulatory cells and the diminishing of antitumor CD8(+) effector T-cells.		[47]
CD8+T-cells	Suppressed cytotoxicity, inhibiting signaling and proliferation, increased apoptosis, and alteration of antitumor phenotype.	Promote the proliferation of all T-cells	[47,48]