O Papel das Células Supressoras Derivadas de Mieloides na Imunopatogênese do Linfoma de Hodgkin: Revisão Integrativa da Literatura
DOI:
https://doi.org/10.32635/2176-9745.RBC.2026v72n4.5715Palavras-chave:
Neoplasias Hematológicas, Células Supressoras Mieloides, Doença de Hodgkin, Microambiente Tumoral, Terapia de ImunossupressãoResumo
Introdução: O linfoma de Hodgkin (LH) é uma neoplasia hematológica caracterizada pela presença das células de Hodgkin e Reed-Sternberg, imersas em um microambiente tumoral rico em mediadores inflamatórios e células imunes, cuja composição desempenha papel central na progressão da doença e na evasão da resposta imune, destacando-se, nesse contexto, as células supressoras derivadas de mieloides (MDSC) como reguladoras da imunidade antitumoral. Objetivo: Sintetizar criticamente as evidências disponíveis sobre o papel das MDSC na imunopatogênese do LH, com ênfase em seus subtipos fenotípicos, mecanismos de ação e relevância clínica. Método: Revisão da literatura baseada na análise crítica de estudos experimentais e clínicos recuperados de bases de dados nacionais e internacionais que abordaram a interação entre MDSC, células tumorais e o microambiente tumoral no LH. Resultados: Os estudos analisados demonstram que as MDSC encontram-se aumentadas em pacientes com LH e associam-se a pior prognóstico, maior carga tumoral e menor resposta às terapias convencionais, exercendo efeitos imunossupressores por meio da produção de arginase, óxido nítrico, espécies reativas de oxigênio e citocinas anti-inflamatórias, além de favorecerem a expansão de células T reguladoras e inibirem a atividade citotóxica de linfócitos T e células natural killer, bem como interagirem com outras populações mieloides no microambiente tumoral. Conclusão: Em conjunto, as evidências sustentam um papel central das MDSC na imunopatogênese do LH, influenciando a dinâmica do microambiente tumoral e a resposta terapêutica, o que pode contribuir para o desenvolvimento de novas estratégias imunomodulatórias e para a identificação de biomarcadores prognósticos e preditivos.
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