Professional APCs, epithelial cells, vascular endothelium, and tumor cells all express indoleamine-2,3-dioxygenase (IDO), an intracellular enzyme that catalyzes the first and rate-limiting step in the degradation pathway of the essential amino acid tryptophan. IDO is a crucial enzyme in the initiation and spread of cancer. It encourages tumor angiogenesis, immune tolerance to tumor antigens in stromal and immune cells, suppression of T and NK cells, production and activation of T regulatory cells (Tregs), and myeloid-derived suppressor cells. It also supports inflammation in the tumor microenvironment.According to reports, functionally active IDO protein is expressed in a wide range of human hematologic malignancies, including breast cancer, colorectal cancer, endometrial cancer, gastric cancer, glioblastoma, gynecological cancers, head and neck cancers, non-small cell lung cancer (NSCLC), melanoma, and pancreatic cancer. The IDO pathway is emerging as a crucial method for the treatment of cancer as an immune checkpoint pathway.
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