Abstract
Malignant glioma induced immunosuppression is one of the major hurdles in the way of designing successful antiglioma therapy. Several factors, such as inhibitory dendritic cells (DCs), regulatory T cells (Tregs), inhibitory enzymes, and cytokines contribute to orchestrate a very redundant and potent immunosuppressive microenvironment. Two of the most influential and hence most studied players associated with glioma immunosuppression are Treg and indoleamine-2,3-dioxygenase (IDO), an enzyme, expressed by glioma cells and inhibitory plasmacytoid DCs. Several preclinical studies have shown that targeting Tregs and IDO is a successful and well-tolerated strategy of inducing potent antiglioma response. Based on these results, strategies of Treg depletion and targeting IDO have been tried in clinical settings. In this chapter, we review the literature summarizing the role of Tregs and IDO in glioma immunosuppression and outline the preclinical works, which led to the development of several successful clinical trials to overcome glioma immunosuppression and boost antiglioma immunotherapy.
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