几十年来已经被认识到，肿瘤细胞外基质（ECM）存在功能异常，导致组织结构丧失和肿瘤生长促进。改变的ECM和肿瘤纤维形成导致组织硬度，从而作为机械性屏障阻碍免疫细胞渗透到肿瘤微环境（TME）中。逐渐明确，ECM在肿瘤免疫应答中起着重要作用。越来越多的数据表明，当ECM组分发生异常时，其作为配体与免疫细胞上的受体相互作用，抑制了TME中的免疫细胞亚群，ECM组分也在免疫调控中发挥更积极的作用。此外，用于治疗癌症的免疫疗法，如检查点抑制剂，通常受到ECM变化的阻碍。在本综述中，我们重点强调ECM改变如何影响和调控肿瘤中的免疫。更具体地说，我们将重点评述胶原蛋白和主要的ECM组分在复杂的TME中如何抑制免疫。最后，我们将回顾我们对ECM对免疫和免疫疗法调控的加深认识正朝着破坏性的新策略来克服免疫抑制的方向发展。版权所有 © 2023 Flies, Langermann, Jensen, Karsdal和Willumsen。

It has been known for decades that the tumor extracellular matrix (ECM) is dysfunctional leading to loss of tissue architecture and promotion of tumor growth. The altered ECM and tumor fibrogenesis leads to tissue stiffness that act as a physical barrier to immune cell infiltration into the tumor microenvironment (TME). It is becoming increasingly clear that the ECM plays important roles in tumor immune responses. A growing body of data now indicates that ECM components also play a more active role in immune regulation when dysregulated ECM components act as ligands to interact with receptors on immune cells to inhibit immune cell subpopulations in the TME. In addition, immunotherapies such as checkpoint inhibitors that are approved to treat cancer are often hindered by ECM changes. In this review we highlight the ways by which ECM alterations affect and regulate immunity in cancer. More specifically, how collagens and major ECM components, suppress immunity in the complex TME. Finally, we will review how our increased understanding of immune and immunotherapy regulation by the ECM is leading towards novel disruptive strategies to overcome immune suppression.Copyright © 2023 Flies, Langermann, Jensen, Karsdal and Willumsen.