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Mini Review - (2022) Volume 10, Issue 8

Lactate and Succinate, Oncometabolites, Activate Pro-Angiogenic Macrophages in Malignancies.

Nicola Rocco*
 
Department of Medical Oncology, VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands
 
*Correspondence: Nicola Rocco, Department of Medical Oncology, VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands, Email:

Received: 01-Aug-2022, Manuscript No. IPACR-22-12947; Editor assigned: 03-Aug-2022, Pre QC No. IPACR-22-12947; Reviewed: 17-Aug-2022, QC No. IPACR-22-12947; Revised: 22-Aug-2022, Manuscript No. IPACR-22-12947; Published: 30-Aug-2022, DOI: 10.36648/2254-6081-10.8-141

Abstract

Macrophages area unit innate vegetative cell leukocytes that area unit extremely gift in solid tumors, wherever they're brought up as tumor-associated macrophages (TAMs). In solid tumors, the microenvironment is commonly immunological disorder and hypoxic regions area unit current. These hypoxic conditions impose growth cells to reprogram their metabolism, shifting from organic process to anaerobic metabolic process. This alleged glycolytic switch permits hypoxic growth cells to survive, proliferate, and eventually to out compete untransformed cells. The hypoxia-induced modification in growth cell metabolism results in the assembly of oncometabolites, among that area unit the glycolytic end-metabolite wet-nurse and also the tricarboxylic acid cycle intermediate succinate. TAMs will react to those oncometabolites, leading to AN altered maturation and also the adoption of pro-angiogenic options. These angiogenesis-promoting TAMs are according to work with growth cells within the formation of recent vessels, and even are thought-about a very important reason for resistance against anti-angiogenic therapies.

Keywords

Pre-cancer tumor; Resistance metastasis; Cancer transitions; Singlecell genomics; Spatial genomics; Cell leukocytes

Introduction

Tumor-associated macrophages (TAMs) area unit legendary promoters of growth neovascularization, and considerably contribute to the emergence of resistance to anti-angiogenic therapies. Recent proof suggests that the maturation promoting composition of TAMs may be activated by hypoxic growth cellderived oncometabolites, together with wet-nurse and succinate. Here, the most recent findings into the lactate- and succinatemediated mechanistic activation of pro-angiogenic TAMs area unit reviewed, and therapeutic methods that interfere with this mechanism and will delay or perhaps forestall no heritable resistance to anti-angiogenic agents area unit mentioned.

Macrophages area unit massive leukocytes that reside among much each tissue of the body in search of pathogens or dead cells that they'll eliminate via activity these massive phagocytes area unit the foremost plastic cells of the haematogenic system and might exert a large form of functions, starting from immune functions to physiological state and tissue repair [1].

In solid tumors, macrophages area unit usually the foremost common immune cell sort, generally creating up over five hundredth of the entire cell mass whereas most macrophages in traditional tissues primarily have pro-immune functions and contribute to physiological state tumor-associated macrophages (TAMs) usually have veteran a deviated maturation profile, leading to AN immunological disorder and pro-angiogenic composition. Such TAMs support growth, and area unit characteristic for higher stage tumors [2].

Oxygen sensing is AN elaborately regulated method that clothed to be a Nobel conception in biology. In solid tumors gas sensing is altered usually leading to the presence of hypoxic areas. Macrophages area unit drawn to these hypoxic growth sites by numerous chemotactic stimuli that area unit secreted by growth cells beneath low gas pressure. Once arrived in hypoxic growth areas, phagocyte motility becomes impaired by the direct effects of drive; leading to TAMs that area unit unfreeze at ischaemic growth sites. This would possibly justify why in some cancer sorts, cap densities area unit according to be highest within the hypoxic/necrotic areas of a growth.

In addition to recruiting macrophages, hypoxic growth cells area unit able to activate a pro-angiogenic composition in TAMs. Drive induces the drive inducible issue (HIF)-1, a transcription issue that powerfully activates tube epithelium protein (VEGF) expression [3]. VEGF is understood to supply AN immune restrictive microenvironment at multiple levels additionally stimulating the event of macrophages into myeloid derived suppressor cells. HIF-1 additionally up regulates GLUT1, a factor vital for aldohexose uptake likewise as genes concerned within the glycolytic pathway that permits growth cells to modify from organic process to anaerobic metabolic process. This glycolytic shift in cancer cells is amid the improved production of the glycolytic end-metabolite wet-nurses and also the tricarboxylic acid (TCA) cycle intermediate succinate. throughout metabolic process, one aldohexose molecule is born-again into 2 pyruvate molecules, and these pyruvate molecules area unit later on employed by wet-nurse dehydrogenases (LDHs) to create lactate; the tip product of metabolic process.

The aerobic pathway, on the opposite hand, is interrupted in hypoxic and/or extremely glycolytic growth cells. The TCA cycle is according to be interrupted at 2 major points in glycolytic growth cells, giving rise to high levels of turn and succinate severally each wet-nurse and succinate will later on become free by growth cells into the growth microenvironment (TME), wherever they're perceived by macrophages via transporters and/or receptors gift on their cell surface. This ends up in the sensing-mediated enlisting of monocytes/macrophages, and a lot of significantly, the induction of a pro-tumoral and pro-angiogenic phagocyte activation state.

TAMs that exhibit this growth promoting composition are according to work with growth cells within the induction of angiogenic neovascularization, and even are thought-about a very important reason for resistance against anti-angiogenic therapies [4,5]. Like growth cells, these TAMs support maturation via the secretion of many pro-angiogenic factors. Once the pro-angiogenic factors prevail the anti-angiogenic stimuli, the angiogenic switch in epithelium cells is iatrogenic, leading to the activation, proliferation, and migration of those cells into tubelike structures the ultimate neovasculature permits cancer cells to proliferate more and to pass around to distant body components.

Discussion

Macrophages area unit innate immune cells that play a important role in each the first-line innate reaction and accommodative immunity. These massive immune cells will exert numerous functions, counting on their composition activation state totally different micro environmental cues induce distinct organic phenomenon patterns that ultimately verify the functions and/or composition of a phagocyte. The latter is commonly brought up as phagocyte â??activationâ? or â??polarizationâ?.

For a protracted time, the mechanisms by that wet-nurse and succinate activated the pro-angiogenic phagocyte composition in TAMs weren't understood. Scientists currently begin to grasp some, however not all underlying mechanisms for oncometabolites-mediated growth supporting phagocyte activation. This review discusses the importance of various TME conditions within the activation of the various phagocyte phenotypes. Additionally, the role of drive within the enlisting and polarization of tumor-promoting macrophages and also the future induction of maturation is reviewed. What is more, the most recent findings on the metabolites wet-nurse and succinate in pro-tumoral phagocyte activation and angiogenic neovascularization area unit summarized. Lastly, many ways that to focus on oncometabolites production, transport, and/or sign area unit planned.

Already since the 1990's, researchers are attempting to reason macrophages supported their composition activation state. At first, a transparent distinction was created in analysis between the classically activated â??M1â? macrophages that function the body's 1st line defense, and also the instead activated â??M2â? macrophages that act in later stages of inflammation. in line with this early organization, M1 macrophages area unit delineated as macrophages that become activated by bacterial-derived merchandise like lipopolysaccharides (LPS), and/or infectionassociated merchandise like interferon-γ (IFN-γ) . Upon activation, M1 macrophages primarily show disinfectant activities and categorical high levels of CD86, inducible gas synthase (iNOS), and pro-inflammatory cytokines, like lymphokine and growth gangrene issue M2 macrophages on the opposite hand, area unit activated by the Th2 cytokines IL-4 and IL- and numerous parasiteassociated signals. When activation, they're preponderantly concerned within the moistening of sort I inflammation and promoting tissue-repair and healing responses. Typical for M2 macrophages is that the expression of high levels of CD206, CD163, medicament cytokines IL-10 and remodelling protein (TGF)-β, and also the catalyst arginase-1 (Arg1) [6-9].

Arginase catalyses the chemical reaction of L-arginine to L-ornithine and organic compound L-ornithine and organic compound become more metabolized into aminoalkanoic acid and polyamines, Nevertheless, over the past years, the constraints of the models that divide macrophages into either classically activated M1 or instead activated M2 macrophages became clear, as these 2 extremes nearly ne'er totally occurred in vivo. Nowadays, researchers believe that the purposeful polarization of macrophages ought to be thought to be a dynamic time, with macrophages exhibiting a composition between M1 and M2, and displaying characteristics of each phenotype at a similar time [10- 12]. This has junction rectifier to the event of recent phagocyte classification systems that expanded the binary M1/M2 system.

TAMs will exert a large form of functions, starting from growth repressive to growth promoting activities. However, a lot of proof has been gathered for the latter. TAMs are according to be poor substance presenters and to impair lymphocyte effector functions. Moreover, several studies have shown that the next density of TAMs is related to accumulated growth malignancy, increased growth cell proliferation, and accumulated numbers of regulative T cells (Tregs), likewise as higher vessel densities. A meta-analysis showed that higher intratumoral phagocyte densities area unit related to a poorer prognosis and overall survival of patients, suggesting the importance of TAMs in malady progression [13-15].

Conclusion

Reducing angiogenic neovascularization in tumours and skewing TAMs toward an anti-tumor phenotype are two effects of therapeutic suppression of LDHs and/or MCTs. The lactate-based metabolic symbiosis, which has been shown to be important in the development of resistance to anti-angiogenic therapy, has also been found to be affected by MCT overexpression. Targeting these transporters and/or increasing tumour cells' usage of glycolysis appear promising for extending the time that patients respond to anti-angiogenic therapy (Fig. 3). To examine the potential of therapies that interfere with metabolic symbiosis in delaying or even preventing acquired resistance to antiangiogenic agents, additional research into the use of therapies that combine anti-angiogenic agents with agents that inhibit glycolysis and/or lactate shuttling is desired.

Acknowledgement

I would like to thank my professor for his support and encouragement.

Conflict of Interest

The authors declare that there is no conflict of interest.

References

  1. Wynn TA, Chawla A,Pollard JW (2013) Macrophage biology in development, homeostasis and disease. Nature496: 445-455.
  2. Indexed at, Google Scholar, Crossref

  3. Lewis CE,Leek R, Harris A, McGee JO (1995) Cytokine regulation of angiogenesis in breast cancer: the role of tumor-associated macrophages. J Leukoc Biol57: 747-751.
  4. Indexed at, Google Scholar, Crossref

  5. DirkxA ME, Oude Egbrink MGA, Wagstaff J, Griffioen AW (2006) Monocyte/macrophage infiltration in tumors: modulators of angiogenesis. J Leukoc Biol 80: 1183-1196.
  6. Indexed at, Google Scholar, Crossref

  7. Balkwill F, Mantovani  A (2001) Inflammation and cancer: Back to Virchow? Lancet 357:539-545.
  8. Indexed at, Google Scholar, Crossref

  9. Semenza GL (2012) Hypoxia-inducible factors: mediators of cancer progression and targets for cancer therapy.Trends Pharmacol Sci 33: 207-214.
  10. Indexed at, Google Scholar, Crossref

  11. Griffioen AW, Bischoff J (2019) Oxygen sensing decoded: a Nobel concept in biology. Angiogenesis22: 471-472.
  12. Indexed at, Google Scholar, Crossref

  13. Chanmee T,Ontong P, Konno K,Itano N (2014) Tumor-associated macrophages as major players in the tumor microenvironment.Cancers (Basel) 6: 1670-1690.
  14. Indexed at, Google Scholar, Crossref

  15. Grimshaw MJ, Balkwill FR (2001) Inhibition of monocyte and macrophage chemotaxis by hypoxia and inflammation--a potential mechanism. Eur J Immunol 31: 480-489.
  16. Indexed at, Google Scholar, Crossref

  17. Lewis JS,Landers RJ,Underwood JC,Harris AL, Lewis CE (2000) Expression of vascular endothelial growth factor by macrophages is up-regulated in poorly vascularized areas of breast carcinomas. J Pathol192: 150-158.
  18. Indexed at, Google Scholar, Crossref

  19. Leek RD, Landers RJ, Harris AL, Lewis CE (1999) Necrosis correlates with high vascular density and focal macrophage infiltration in invasive carcinoma of the breast. Br J Cancer79: 991-995.
  20. Indexed at, Google Scholar, Crossref

  21. Negus RPM,JW Stamp,Hadley J, Balkwill FR (1997) Quantitative assessment of the leukocyte infiltrate in ovarian cancer and its relationship to the expression of C-C chemokines. Am J Pathol 150: 1723-1734.
  22. Indexed at, Google Scholar

  23. Henze AT,Mazzone M (2016) The impact of hypoxia on tumor-associated macrophages. J Clin Invest 126: 3672-3679.
  24. Indexed at, Google Scholar, Crossref

  25. Hillen F,Griffioen AW (2007) Tumour vascularization: sprouting angiogenesis and beyond. Cancer Metastasis Rev 26: 489-502.
  26. Indexed at, Google Scholar, Crossref

  27. Gabrilovich DI,Chen HL, Girgis KR, Carbone DP, Kavanaugh Det al. (1996) Production of vascular endothelial growth factor by human tumors inhibits the functional maturation of dendritic cells. Nat Med 2: 1096-1103.
  28. Indexed at, Google Scholar, Crossref

  29. Fang HY,Hughes R, Murdoch C,Randall SJ, Hongxia ZI et al. (2009) Hypoxia-inducible factors 1 and 2 are important transcriptional effectors in primary macrophages experiencing hypoxia. Blood 114: 844-859.
  30. Indexed at, Google Scholar, Crossref

Keywords

Pre-cancer tumor; Resistance metastasis; Cancer transitions; Singlecell genomics; Spatial genomics; Cell leukocytes

Introduction

Tumor-associated macrophages (TAMs) area unit legendary promoters of growth neovascularization, and considerably contribute to the emergence of resistance to anti-angiogenic therapies. Recent proof suggests that the maturation promoting composition of TAMs may be activated by hypoxic growth cellderived oncometabolites, together with wet-nurse and succinate. Here, the most recent findings into the lactate- and succinatemediated mechanistic activation of pro-angiogenic TAMs area unit reviewed, and therapeutic methods that interfere with this mechanism and will delay or perhaps forestall no heritable resistance to anti-angiogenic agents area unit mentioned.

Macrophages area unit massive leukocytes that reside among much each tissue of the body in search of pathogens or dead cells that they'll eliminate via activity these massive phagocytes area unit the foremost plastic cells of the haematogenic system and might exert a large form of functions, starting from immune functions to physiological state and tissue repair [1].

In solid tumors, macrophages area unit usually the foremost common immune cell sort, generally creating up over five hundredth of the entire cell mass whereas most macrophages in traditional tissues primarily have pro-immune functions and contribute to physiological state tumor-associated macrophages (TAMs) usually have veteran a deviated maturation profile, leading to AN immunological disorder and pro-angiogenic composition. Such TAMs support growth, and area unit characteristic for higher stage tumors [2].

Oxygen sensing is AN elaborately regulated method that clothed to be a Nobel conception in biology. In solid tumors gas sensing is altered usually leading to the presence of hypoxic areas. Macrophages area unit drawn to these hypoxic growth sites by numerous chemotactic stimuli that area unit secreted by growth cells beneath low gas pressure. Once arrived in hypoxic growth areas, phagocyte motility becomes impaired by the direct effects of drive; leading to TAMs that area unit unfreeze at ischaemic growth sites. This would possibly justify why in some cancer sorts, cap densities area unit according to be highest within the hypoxic/necrotic areas of a growth.

In addition to recruiting macrophages, hypoxic growth cells area unit able to activate a pro-angiogenic composition in TAMs. Drive induces the drive inducible issue (HIF)-1, a transcription issue that powerfully activates tube epithelium protein (VEGF) expression [3]. VEGF is understood to supply AN immune restrictive microenvironment at multiple levels additionally stimulating the event of macrophages into myeloid derived suppressor cells. HIF-1 additionally up regulates GLUT1, a factor vital for aldohexose uptake likewise as genes concerned within the glycolytic pathway that permits growth cells to modify from organic process to anaerobic metabolic process. This glycolytic shift in cancer cells is amid the improved production of the glycolytic end-metabolite wet-nurses and also the tricarboxylic acid (TCA) cycle intermediate succinate. throughout metabolic process, one aldohexose molecule is born-again into 2 pyruvate molecules, and these pyruvate molecules area unit later on employed by wet-nurse dehydrogenases (LDHs) to create lactate; the tip product of metabolic process.

The aerobic pathway, on the opposite hand, is interrupted in hypoxic and/or extremely glycolytic growth cells. The TCA cycle is according to be interrupted at 2 major points in glycolytic growth cells, giving rise to high levels of turn and succinate severally each wet-nurse and succinate will later on become free by growth cells into the growth microenvironment (TME), wherever they're perceived by macrophages via transporters and/or receptors gift on their cell surface. This ends up in the sensing-mediated enlisting of monocytes/macrophages, and a lot of significantly, the induction of a pro-tumoral and pro-angiogenic phagocyte activation state.

TAMs that exhibit this growth promoting composition are according to work with growth cells within the induction of angiogenic neovascularization, and even are thought-about a very important reason for resistance against anti-angiogenic therapies [4,5]. Like growth cells, these TAMs support maturation via the secretion of many pro-angiogenic factors. Once the pro-angiogenic factors prevail the anti-angiogenic stimuli, the angiogenic switch in epithelium cells is iatrogenic, leading to the activation, proliferation, and migration of those cells into tubelike structures the ultimate neovasculature permits cancer cells to proliferate more and to pass around to distant body components.

Discussion

Macrophages area unit innate immune cells that play a important role in each the first-line innate reaction and accommodative immunity. These massive immune cells will exert numerous functions, counting on their composition activation state totally different micro environmental cues induce distinct organic phenomenon patterns that ultimately verify the functions and/or composition of a phagocyte. The latter is commonly brought up as phagocyte â??activationâ? or â??polarizationâ?.

For a protracted time, the mechanisms by that wet-nurse and succinate activated the pro-angiogenic phagocyte composition in TAMs weren't understood. Scientists currently begin to grasp some, however not all underlying mechanisms for oncometabolites-mediated growth supporting phagocyte activation. This review discusses the importance of various TME conditions within the activation of the various phagocyte phenotypes. Additionally, the role of drive within the enlisting and polarization of tumor-promoting macrophages and also the future induction of maturation is reviewed. What is more, the most recent findings on the metabolites wet-nurse and succinate in pro-tumoral phagocyte activation and angiogenic neovascularization area unit summarized. Lastly, many ways that to focus on oncometabolites production, transport, and/or sign area unit planned.

Already since the 1990's, researchers are attempting to reason macrophages supported their composition activation state. At first, a transparent distinction was created in analysis between the classically activated â??M1â? macrophages that function the body's 1st line defense, and also the instead activated â??M2â? macrophages that act in later stages of inflammation. in line with this early organization, M1 macrophages area unit delineated as macrophages that become activated by bacterial-derived merchandise like lipopolysaccharides (LPS), and/or infectionassociated merchandise like interferon-γ (IFN-γ) . Upon activation, M1 macrophages primarily show disinfectant activities and categorical high levels of CD86, inducible gas synthase (iNOS), and pro-inflammatory cytokines, like lymphokine and growth gangrene issue M2 macrophages on the opposite hand, area unit activated by the Th2 cytokines IL-4 and IL- and numerous parasiteassociated signals. When activation, they're preponderantly concerned within the moistening of sort I inflammation and promoting tissue-repair and healing responses. Typical for M2 macrophages is that the expression of high levels of CD206, CD163, medicament cytokines IL-10 and remodelling protein (TGF)-β, and also the catalyst arginase-1 (Arg1) [6-9].

Arginase catalyses the chemical reaction of L-arginine to L-ornithine and organic compound L-ornithine and organic compound become more metabolized into aminoalkanoic acid and polyamines, Nevertheless, over the past years, the constraints of the models that divide macrophages into either classically activated M1 or instead activated M2 macrophages became clear, as these 2 extremes nearly ne'er totally occurred in vivo. Nowadays, researchers believe that the purposeful polarization of macrophages ought to be thought to be a dynamic time, with macrophages exhibiting a composition between M1 and M2, and displaying characteristics of each phenotype at a similar time [10- 12]. This has junction rectifier to the event of recent phagocyte classification systems that expanded the binary M1/M2 system.

TAMs will exert a large form of functions, starting from growth repressive to growth promoting activities. However, a lot of proof has been gathered for the latter. TAMs are according to be poor substance presenters and to impair lymphocyte effector functions. Moreover, several studies have shown that the next density of TAMs is related to accumulated growth malignancy, increased growth cell proliferation, and accumulated numbers of regulative T cells (Tregs), likewise as higher vessel densities. A meta-analysis showed that higher intratumoral phagocyte densities area unit related to a poorer prognosis and overall survival of patients, suggesting the importance of TAMs in malady progression [13-15].

Conclusion

Reducing angiogenic neovascularization in tumours and skewing TAMs toward an anti-tumor phenotype are two effects of therapeutic suppression of LDHs and/or MCTs. The lactate-based metabolic symbiosis, which has been shown to be important in the development of resistance to anti-angiogenic therapy, has also been found to be affected by MCT overexpression. Targeting these transporters and/or increasing tumour cells' usage of glycolysis appear promising for extending the time that patients respond to anti-angiogenic therapy (Fig. 3). To examine the potential of therapies that interfere with metabolic symbiosis in delaying or even preventing acquired resistance to antiangiogenic agents, additional research into the use of therapies that combine anti-angiogenic agents with agents that inhibit glycolysis and/or lactate shuttling is desired.

Acknowledgement

I would like to thank my professor for his support and encouragement.

Conflict of Interest

The authors declare that there is no conflict of interest.

References

  1. Wynn TA, Chawla A,Pollard JW (2013) Macrophage biology in development, homeostasis and disease. Nature496: 445-455.
  2. Indexed at, Google Scholar, Crossref

  3. Lewis CE,Leek R, Harris A, McGee JO (1995) Cytokine regulation of angiogenesis in breast cancer: the role of tumor-associated macrophages. J Leukoc Biol57: 747-751.
  4. Indexed at, Google Scholar, Crossref

  5. DirkxA ME, Oude Egbrink MGA, Wagstaff J, Griffioen AW (2006) Monocyte/macrophage infiltration in tumors: modulators of angiogenesis. J Leukoc Biol 80: 1183-1196.
  6. Indexed at, Google Scholar, Crossref

  7. Balkwill F, Mantovani  A (2001) Inflammation and cancer: Back to Virchow? Lancet 357:539-545.
  8. Indexed at, Google Scholar, Crossref

  9. Semenza GL (2012) Hypoxia-inducible factors: mediators of cancer progression and targets for cancer therapy.Trends Pharmacol Sci 33: 207-214.
  10. Indexed at, Google Scholar, Crossref

  11. Griffioen AW, Bischoff J (2019) Oxygen sensing decoded: a Nobel concept in biology. Angiogenesis22: 471-472.
  12. Indexed at, Google Scholar, Crossref

  13. Chanmee T,Ontong P, Konno K,Itano N (2014) Tumor-associated macrophages as major players in the tumor microenvironment.Cancers (Basel) 6: 1670-1690.
  14. Indexed at, Google Scholar, Crossref

  15. Grimshaw MJ, Balkwill FR (2001) Inhibition of monocyte and macrophage chemotaxis by hypoxia and inflammation--a potential mechanism. Eur J Immunol 31: 480-489.
  16. Indexed at, Google Scholar, Crossref

  17. Lewis JS,Landers RJ,Underwood JC,Harris AL, Lewis CE (2000) Expression of vascular endothelial growth factor by macrophages is up-regulated in poorly vascularized areas of breast carcinomas. J Pathol192: 150-158.
  18. Indexed at, Google Scholar, Crossref

  19. Leek RD, Landers RJ, Harris AL, Lewis CE (1999) Necrosis correlates with high vascular density and focal macrophage infiltration in invasive carcinoma of the breast. Br J Cancer79: 991-995.
  20. Indexed at, Google Scholar, Crossref

  21. Negus RPM,JW Stamp,Hadley J, Balkwill FR (1997) Quantitative assessment of the leukocyte infiltrate in ovarian cancer and its relationship to the expression of C-C chemokines. Am J Pathol 150: 1723-1734.
  22. Indexed at, Google Scholar

  23. Henze AT,Mazzone M (2016) The impact of hypoxia on tumor-associated macrophages. J Clin Invest 126: 3672-3679.
  24. Indexed at, Google Scholar, Crossref

  25. Hillen F,Griffioen AW (2007) Tumour vascularization: sprouting angiogenesis and beyond. Cancer Metastasis Rev 26: 489-502.
  26. Indexed at, Google Scholar, Crossref

  27. Gabrilovich DI,Chen HL, Girgis KR, Carbone DP, Kavanaugh Det al. (1996) Production of vascular endothelial growth factor by human tumors inhibits the functional maturation of dendritic cells. Nat Med 2: 1096-1103.
  28. Indexed at, Google Scholar, Crossref

  29. Fang HY,Hughes R, Murdoch C,Randall SJ, Hongxia ZI et al. (2009) Hypoxia-inducible factors 1 and 2 are important transcriptional effectors in primary macrophages experiencing hypoxia. Blood 114: 844-859.
  30. Indexed at, Google Scholar, Crossref

Citation: Rocco N (2022) Lactate and succinate, oncometabolites, activate pro-angiogenic macrophages in malignancies. Archives Can Res, Vol.10 No.Issue 8:141