Adenosine (Ado), mainly produced by the hydrolysis of ATP, exhibits
significantly elevated levels in the tumor microenvironment (TME)
compared to normal tissues. Upon binding to adenosine receptors (AdoRs),
Ado initiates downstream signaling pathways that suppress tumor antigen
presentation and immune cell activation, thereby inhibiting tumor
adaptive immunity. Ado downregulates major histocompatibility complex II
(MHC II) and co-stimulatory factors expression on DCs and macrophages,
thereby inhibiting antigen presentation to T cells. Ado inhibits the
binding of the T cell receptor (TCR) to its ligand and transmembrane
signal transduction on T cells, thus suppressing anti-tumor cytokines
secretion and inhibiting T cell activation. Ado also inhibits the
secretion of chemokines and the KCa3.1 channel, thereby suppressing the
trafficking and infiltration of effector T cells into the tumor site.
Moreover, Ado inhibits the cytotoxicity of T cells against tumor cells
by promoting the secretion of immune-suppressive cytokines, increasing
the expression of immune checkpoint proteins, and enhancing the activity
of immune-suppressive cells. Due to the inhibitory effects of Ado on
tumor adaptive immunity, reducing Ado production in the TME can exert
significant anti-tumor immune effects and enhance the efficacy of other
immunotherapies. Various inhibitors blocking Ado generation or AdoRs are
now under preclinical or clinical development. Therefore, this article
will summarize and analyze the inhibitory effects and molecular
mechanisms of Ado on tumor adaptive immunity, as well as provide an
overview of the latest advancements in targeting Ado pathways in
anti-tumor immune responses.