Pancreatic ductal adenocarcinoma (PDAC) features an immunosuppressive tumor microenvironment (TME) that resists immunotherapy. Tumor-associated macrophages, abundant in the TME, modulate T cell responses. Bone marrow stromal antigen 2-positive (BST2 + ) macrophages increase in Kras G12D/+ ; Trp53 R172H/+ ; Pdx1-Cre mouse models during PDAC progression. However, their role in PDAC remains elusive. Our findings reveal a negative correlation between BST2 + macrophage levels and PDAC patient prognosis. Moreover, an increased ratio of exhausted CD8 + T cells is observed in tumors with up-regulated BST2 + macrophages. Mechanistically, BST2 + macrophages secrete CXCL7 through the ERK pathway and bind with CXCR2 to activate the AKT/mTOR pathway, promoting CD8 + T cell exhaustion. The combined blockade of CXCL7 and programmed death-ligand 1 successfully decelerates tumor growth. Additionally, cGAS-STING pathway activation in macrophages induces interferon (IFN)α synthesis leading to BST2 overexpression in the PDAC TME. This study provides insights into IFNα-induced BST2 + macrophages driving an immune-suppressive TME through ERK-CXCL7 signaling to regulate CD8 + T cell exhaustion in PDAC.
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