“…The tumor-promoting functions comprise (i) remodeling of the TME ( 196 ), (ii) induction of (lymph)angiogenesis ( 196 ), (iii) promotion of metastasis ( 197 ), (iv) inhibition of cellular senescence ( 198 ), (v) suppression of T-cell function and migration ( 199 , 200 ) and (vi) resistance to chemo-and immunotherapy ( 201 – 203 ). It is important to note that the immunosuppressive activity of MDSCs is not limited to a single mechanism, with MDSCs engaging several mechanisms throughout the progression of the tumor ( 6 , 204 – 206 ), including; (i) expansion of Tregs ( 207 ), (ii) expression of galectin-9 on the MDSC surface, resulting in T-cell apoptosis ( 208 ), (iii) inhibition of NK cells through membrane-bound TGFβ1 ( 209 ), (iv) the secretion of ROS [ , H 2 O 2 and peroxynitrite (OONO − )]( 210 , 211 ), (v) expression of enzymes involved in amino acid catabolism, like Arginase-I and IDO, collectively inhibiting T-cell proliferation ( 212 , 213 ), and (vi) secretion of S100A8 and S100A9, resulting in the recruitment of more MDSCs and inhibition of dendritic cell maturation ( 214 , 215 ).…”