Glioma-associated macrophages: unraveling their dual role in the microenvironment and therapeutic implications

Abstract Glioblastoma (GBM) is a malignant brain glioma characterized by a high number of tumor-associated macrophages (TAMs) within its tissues. These TAMs have a close relationship with tumor grade and prognosis. Targeting TAMs has been identified as a promising therapeutic strategy. However, TAM cells play both tumor-killing and tumor-promoting roles, making them a double-edged sword in the immune environment. The different subtypes of macrophages and their effects on the tumor microenvironment remain poorly understood. This study comprehensively elucidates the immunobiology of glioma-associated macrophages (GAMs), including their origin, classification, molecular mechanisms underlying glioma promotion and inhibition, polarization strategies, targeted therapy for GAMs and the current challenges and perspectives in immune modulation. Further research on macrophage function and mechanism may provide a new immunological basis for treating GBM patients and enhancing the efficacy of glioma immunotherapy.