Figure 25.Schematic representation of the dual roles of IDO in cancer. IDO is an important immunomodulatory enzyme produced both by activated macrophages as well as by other immunoregulatory cells and performs its normal immunoregulatory functions by catalyzing the conversion of tryptophan to kynurenine. By consumption of tryptophan and overproduction of kynurenine, IDO upregulation leads to T cell suppression both by blunting T effector cell function as well as recruitment of Treg cells. IDO is also upregulated in cancer cells where it is thought to contribute to the immune subversion strategy used by many tumors. IDO dysregulation may exert its tumor promoting effects through its known ability to inactivate the tumor suppressor gene Bin1 as well as by incapacitating effective immune tumor surveillance mechanisms, thereby promoting tumor growth.

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