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Frontiers of Medicine

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Front. Med.    2021, Vol. 15 Issue (2) : 232-251    https://doi.org/10.1007/s11684-020-0797-2
REVIEW
Recent advances in myeloid-derived suppressor cell biology
Mahmoud Mohammad Yaseen1(), Nizar Mohammad Abuharfeil1, Homa Darmani2, Ammar Daoud3
1. Department of Biotechnology and Genetic Engineering
2. Department of Applied Biology, Faculty of Science and Arts
3. Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
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Abstract

In recent years, studying the role of myeloid-derived suppressor cells (MDSCs) in many pathological inflammatory conditions has become a very active research area. Although the role of MDSCs in cancer is relatively well established, their role in non-cancerous pathological conditions remains in its infancy resulting in much confusion. Our objectives in this review are to address some recent advances in MDSC research in order to minimize such confusion and to provide an insight into their function in the context of other diseases. The following topics will be specifically focused upon: (1) definition and characterization of MDSCs; (2) whether all MDSC populations consist of immature cells; (3) technical issues in MDSC isolation, estimation and characterization; (4) the origin of MDSCs and their anatomical distribution in health and disease; (5) mediators of MDSC expansion and accumulation; (6) factors that determine the expansion of one MDSC population over the other; (7) the Yin and Yang roles of MDSCs. Moreover, the functions of MDSCs will be addressed throughout the text.
Keywords non-human primates (rhesus macaques)      myeloid-derived pro-inflammatory cells (MDPCs)      autoimmune disorders      alloimmune responses      pregnancy      mature MDSCs      multiple sclerosis      Yin-Yang law of MDSCs     
Corresponding Author(s): Mahmoud Mohammad Yaseen   
Just Accepted Date: 24 July 2020   Online First Date: 04 September 2020    Issue Date: 23 April 2021
 Cite this article:   
Mahmoud Mohammad Yaseen,Nizar Mohammad Abuharfeil,Homa Darmani, et al. Recent advances in myeloid-derived suppressor cell biology[J]. Front. Med., 2021, 15(2): 232-251.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-020-0797-2
https://academic.hep.com.cn/fmd/EN/Y2021/V15/I2/232
Fig.1  MDSCs in health and disease. The case number 1 represents healthy subjects without MDSCs expansion. The case number 2 represents a normal physiologic condition, i.e., pregnancy, in which MDSCs expansion occurs during all pregnancy stages and their levels are normalized post-delivery. The case number 3 represents a pathological condition where MDSCs expansion directly correlates with the disease progression.
Fig.2  Expansion of MDSCs during inflammation (e.g., cancer). (1) Produced molecules by tumor/stroma cells initiates (2) a signal that trigger emergency myelopoiesis in which hematopoietic progenitor cells (HPCs) transit to common myeloid progenitors (CMPs). These CMPs continue the differentiation process to immature myeloid cells (IMCs). (3) Some of them will be able to continue the differentiation process normally (the so-called normal-IMC (N-IMC)) to generated mature monocytes/dendritic cells (Mo/DCs) and polymorphonuclear neutrophils (PMNs) in the bone marrow. (4) Then these cells can be released to periphery (blood circulation and tissues). (5) The other portion of IMCs cannot continue their normal differentiation to Mo/DCs or PMNs, since their differentiation is blocked at this immature stage (the so-called blocked-IMC (B-IMC)) in response to tumor/inflammation signal. (6) These cells could acquire immunosuppressive activity signal so that we called them immature-myeloid derived suppressor cells (immature-MDSCs (i-MDSCs)). (7) As the hematopoietic output is increased, releasing (exporting) both the B-IMCs and N-IMCs to peripheral tissues is normally expected. Once outside the bone marrow, (8) blood B-IMCs could acquire suppressive activity and become i-MDSCs or are recruited to the inflammation sites and/or lymphatic tissues (11). On the other hand, (9) N-IMC could be differentiated to mature cells or recruited to the lymphatic tissues and inflammation sites (11). Furthermore, (10) peripheral blood PMNs and Mo/DCs could be reprogrammed to either i-MDSCs or gain immunosuppressive activity while remain in their mature state, so that we call them mature-MDSCs (m-MDSCs). Alternatively, PMNs and Mo/DCs are recruited to the site of inflammation where they could be reprogrammed to i-MDSCs or m-MDSCs. (12) A similar scenario occurs for B-IMC and N-IMC upon recruitment to lymphatic tissues. Importantly, at the inflammation site, (13) the recruited MDSCs (i-MDSCs and m-MDSCs) to the inflammation site (e.g., tumor) become more suppressive over time as they exposed to tumor-stroma cells and their byproducts. Red arrows, reprogramming; blue arrows, export/homing.
Fig.3  Yin and Yang faces of MDSCs. Natural (without human intervention) MDSCs expansion is considered to be beneficial (Yang face) only if it blunted the inflammation process that in turn consequently results in better clinical outcomes (disease resolution) and their levels returned to the normal level before the inflammation onset started, as seen in the case 1. Otherwise, if the natural expansion of MDSCs is not associated with inflammation resolution, rather, the inflammation continues, then these cells are considered to be directly associated with the disease progression, or could be considered to be pro-inflammatory cells, indicating that they have a Yin face, as seen in the case 2.
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