Fig. 10

The contribution of peritoneal macrophages to the deleterious, pro-tumor effects of 30 day TQ treatment. Extended TQ treatment induced a substantial shift in macrophage phenotype within the tumor microenvironment, to pro-tumor M2-like macrophages. M2 macrophages showed increased levels of macrophage recruiting factors that creates a positive feedback loop further increasing macrophage numbers, and of VEGF, an important angiogenic factor that induces leaky vasculature characteristic of ascites. M2-like macrophages also produced increased signals such as TNFα, which have the ability to increase NF-κB activity in tumors, leading to a treatment-resistant subpopulation of tumor cells