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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2025.1660851</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Immunology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Resveratrol suppresses OSCC invasion and migration by regulating macrophage polarization via Syk signaling pathway</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Weibo</given-names>
</name>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Qi</surname>
<given-names>Ying</given-names>
</name>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Yafei</given-names>
</name>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liu</surname>
<given-names>Lu</given-names>
</name>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dong</surname>
<given-names>Xiaodan</given-names>
</name>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Li</surname>
<given-names>Bo</given-names>
</name>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2290760/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
</contrib>
</contrib-group>
<aff id="aff1">
<institution>Department of Oral Anatomy and Physiology, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, Hospital of Stomatology, Jilin University</institution>, <addr-line>Changchun</addr-line>,&#xa0;<country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/556122/overview">Jiong Chen</ext-link>, Ningbo University, China</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/773697/overview">Peng Zhang</ext-link>, Sichuan University, China</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/2693093/overview">Jiafeng Cao</ext-link>, Ningbo University, China</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Bo Li, <email xlink:href="mailto:lbo@jlu.edu.cn">lbo@jlu.edu.cn</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>29</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1660851</elocation-id>
<history>
<date date-type="received">
<day>07</day>
<month>07</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>09</day>
<month>09</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Li, Qi, Li, Liu, Dong and Li.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Li, Qi, Li, Liu, Dong and Li</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>An increasing amount of evidence indicates that the metastasis in oral squamous cell carcinoma (OSCC) is closely associated with the polarization phenotype of tumor-associated macrophages (TAMs). Resveratrol (RES) has been demonstrated to exert an inhibitory effect on the invasion and migration of OSCC cells. However, the mechanism by which RES inhibits OSCC invasion and migration remains to be fully elucidated.</p>
</sec>
<sec>
<title>Methods</title>
<p>RES for reprogramming TAMs (R-RES group) and RES group were used to interfere with the polarization of tumor-associated macrophages (TAMs).  RT-qPCR, ELISA, Western blotting, immunofluorescence staining, transwell and wound-healing assays were used to investigate the anti-tumor mechanism of RES.</p>
</sec>
<sec>
<title>Results</title>
<p>R-RES reprogramed TAMs from M2 to M1 phenotype. RES promoted M1 polarization of TAMs and inhibited M2 polarization of TAMs. In mechanism, inhibition of Syk signaling pathway in TAMs attenuated the invasive and migratory ability of CAL27 cells through promoting M1 polarization of TAMs and inhibiting M2 polarization of TAMs.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>RES suppresses OSCC invasion and migration by regulating the polarization phenotype of TAMs via Syk signaling pathway, further elucidating the anti-tumor mechanism of RES.</p>
</sec>
</abstract>
<abstract abstract-type="graphical">
<title>Graphical abstract</title>
<p>RES suppresses OSCC invasion and migration by regulating the polarization phenotype of TAMs via Syk signaling pathway. RES reprograms TAMs from M2 to M1 phenotype. Meanwhile, it promotes M1 polarization of TAMs and inhibits M2 polarization of TAMs.</p>
<p>
<graphic xlink:href="fimmu-16-1660851-g000.tif" position="anchor">
<alt-text content-type="machine-generated">Diagram showing the interaction of OSCC cells and macrophages. OSCC cells invade, prompting M0 macrophages to become M1 macrophages, marked by iNOS, CD86, IL-12, and TNF-&#x3b1;. Resveratrol reprograms them into M2 macrophages characterized by CD206, Arg-1, IL-10, and TGF-&#x3b2;. M0 macrophages are red, M1 are purple, M2 are green. Resveratrol and cytokines are depicted in other colors.</alt-text>
</graphic>
</p>
</abstract>
<kwd-group>
<kwd>oral squamous cell carcinoma</kwd>
<kwd>tumor-associated macrophages</kwd>
<kwd>resveratrol</kwd>
<kwd>polarization</kwd>
<kwd>invasion</kwd>
<kwd>migration</kwd>
</kwd-group>
<contract-num rid="cn001">20250205010GH</contract-num>
<contract-sponsor id="cn001">Department of Science and Technology of Jilin Province<named-content content-type="fundref-id">10.13039/501100011789</named-content>
</contract-sponsor>
<counts>
<fig-count count="7"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="78"/>
<page-count count="16"/>
<word-count count="6505"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Comparative Immunology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>Oral squamous cell carcinoma (OSCC) constitutes the sixth most prevalent malignant tumor globally, exhibiting a proclivity for cervical lymph node metastasis (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). The five-year survival rate of OSCC is below 50%, which can be attributed to a lack of comprehensive understanding of its invasion and migration mechanisms (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>). It is urgent to further elucidate the mechanism of OSCC invasion and migration, identify new specific targets, and optimize treatment strategies to reduce OSCC mortality. An increasing body of evidence indicates that OSCC invasion and migration are closely associated with tumor-associated macrophages (TAMs) (<xref ref-type="bibr" rid="B5">5</xref>&#x2013;<xref ref-type="bibr" rid="B7">7</xref>).</p>
<p>TAMs within the tumor microenvironment can be categorized into two main phenotypes: M1 (anti-tumor) and M2 (pro-tumor) (<xref ref-type="bibr" rid="B8">8</xref>&#x2013;<xref ref-type="bibr" rid="B10">10</xref>). M2-type TAMs play a critical role in facilitating OSCC invasion and migration (<xref ref-type="bibr" rid="B11">11</xref>, <xref ref-type="bibr" rid="B12">12</xref>) and are closely correlated with the survival rate of OSCC patients (<xref ref-type="bibr" rid="B13">13</xref>). Previous studies reported that M2-type TAMs can be reprogrammed into M1-type TAMs, effectively inhibiting tumor invasion and migration (<xref ref-type="bibr" rid="B14">14</xref>&#x2013;<xref ref-type="bibr" rid="B17">17</xref>). Given the plasticity of the TAM phenotype, the repolarization of immunosuppressive and pro-tumor TAMs into immunostimulating and anti-tumor TAMs through pharmacological stimulation represents a promising strategy for tumor immunotherapy (<xref ref-type="bibr" rid="B18">18</xref>&#x2013;<xref ref-type="bibr" rid="B20">20</xref>). In addition, promoting M1 polarization of TAMs while blocking M2 polarization of TAMs is also a valuable therapeutic strategy (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B21">21</xref>).</p>
<p>Plant extracts exhibit anti-tumor activity through different mechanisms (<xref ref-type="bibr" rid="B22">22</xref>&#x2013;<xref ref-type="bibr" rid="B24">24</xref>). Resveratrol (RES) is a non-toxic, natural polyphenolic compound extracted from plants such as grapes, peanuts, and <italic>Polygonum cuspidatum</italic>, exhibiting an anti-tumor effects by regulating oxidative stress and glucose metabolism (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B25">25</xref>, <xref ref-type="bibr" rid="B26">26</xref>). RES has been demonstrated to exert an inhibitory effect on OSCC invasion and migration via p53/SLC7A11 (<xref ref-type="bibr" rid="B27">27</xref>). RES was found to suppress the invasion and migration of cisplatin-resistant OSCC cells by downregulating the expression of phosphorylated ERK/p38 and MMP-2/9 (<xref ref-type="bibr" rid="B28">28</xref>). RES restrained <italic>Fusobacterium nucleatum</italic>-induced EMT and migration by reducing SNAI1 expression (<xref ref-type="bibr" rid="B29">29</xref>). However, the regulatory role of RES on TAMs and its mechanism in the tumor microenvironment (TME) have not been fully elucidated. Zhang et&#xa0;al. revealed that RES effectively suppressed hepatocellular carcinoma progression by inhibiting TAM/M2 macrophage polarization and activation of the STAT3 pathway, while increasing IFN-&#x3b3;-expressing effector CD8+ T cells in tumor-bearing mice (<xref ref-type="bibr" rid="B30">30</xref>). Chen et&#xa0;al. demonstrated that low-dose resveratrol is effective in controlling renal cell carcinoma growth through (i) inhibition of immunosuppressive cells, (ii) induction of activated and cytotoxic CD8+ T cells, and (iii) modulation of cytokine balance and angiogenesis in the tumor microenvironment (<xref ref-type="bibr" rid="B31">31</xref>). Cheuk et&#xa0;al. demonstrated that treatment with RES reduced the impact of TAM-derived IL-6 on breast cancer progression by promoting M1 polarization of macrophages (<xref ref-type="bibr" rid="B32">32</xref>). In the LLC mice treated with RES, the expression of M2 TAM markers (e.g., IL-10, Arg1, and CD206) was significantly reduced (<xref ref-type="bibr" rid="B33">33</xref>). RES may intervene in cancer progression by modulating the polarization state of TAMs and interrupting the interaction between tumor cells and macrophages (<xref ref-type="bibr" rid="B34">34</xref>).</p>
<p>Spleen tyrosine kinase (Syk) is a non-receptor tyrosine kinase. Emerging studies have recently shown that Syk also contributes to tumor progression (<xref ref-type="bibr" rid="B35">35</xref>). Rohila et&#xa0;al. demonstrated that genetic deletion or pharmacological inhibition of Syk using R788 induces a pro-inflammatory state in macrophages (<xref ref-type="bibr" rid="B36">36</xref>). In a pancreatic ductal adenocarcinoma <italic>in vivo</italic> model, the M2-like TAM phenotype was significantly reduced by a Syk inhibitor (<xref ref-type="bibr" rid="B37">37</xref>). Nevertheless, the role of the Syk pathway in TAM polarization remains unclear.</p>
<p>In this study, RES interfered with the polarization of TAMs in two ways. RES for reprogramming TAMs (R-RES) was added after 24 h induction of macrophages with the conditioned medium of CAL27 cells (CAL27-CM). RES and CAL27-CM were added simultaneously to observe the change in the polarization phenotype of TAMs. The purpose of this study was to investigate whether RES could suppress OSCC invasion and migration by regulating the polarization phenotype of TAMs, and to reveal its specific molecular mechanism.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Cell culture</title>
<p>The human tongue squamous carcinoma cell line CAL27 and the mouse peritoneal macrophage cell line RAW264.7 were purchased from the China Center for Type Culture Collection (CCTCC) and subcultured at the Oral Experimental Teaching Center of Jilin University. The cells were cultured in DMEM (Gibco, USA) supplemented with 10% fetal bovine serum (FBS; BI, Israel) and 1% penicillin-streptomycin double antibody (BI, Israel) in a humidified atmosphere of 5% CO<sub>2</sub> at 37&#xb0;C.</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Collection and preparation of CAL27-CM and induction of TAMs</title>
<p>CAL27 cells were uniformly grown to 80% confluence, washed, and the medium replaced. After 24 h, the supernatant was aspirated, centrifuged at room temperature, filtered through a sterilized 0.22-&#x3bc;M filter, and stored at &#x2212;20&#xb0;C. At the time of use, the tumor supernatant was pre-warmed and mixed with fresh medium at a 7:3 ratio to prepare CAL27-CM for subsequent experiments.</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>Cell viability assay</title>
<p>In 96-well plates, RAW264.7 cells and TAMs (5 &#xd7; 10<sup>5</sup> cells/ml) were incubated with RES (0 &#x3bc;M, 2.5 &#x3bc;M, 5 &#x3bc;M, 10 &#x3bc;M, 20 &#x3bc;M, and 40 &#x3bc;M) (Sigma, Germany) for 24 h. CCK-8 solution (10 &#x3bc;l) was added to each well, and the cells were incubated at 37 &#xb0;C for 4 h. The optical density (OD) at 450 nm was measured using a microplate reader (BioTek, Vermont, USA).</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>Real-time quantitative PCR</title>
<p>Total RNA was extracted from cells using an RNA Extraction Kit (Takara, Japan) and reverse-transcribed into cDNA according to the manufacturer&#x2019;s instructions. For RT-qPCR amplification of TNF-&#x3b1;, IL-12, iNOS, IL-10, Arg-1, and TGF-&#x3b2; from TAMs, targeted sequences were amplified using DNA polymerase. The relative expression of TAM cytokine mRNA was calculated using the 2<sup>&#x2212;&#x394;&#x394;CT</sup> method. <xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref> lists the primers used in this study.</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Primers used for RT-qPCR.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="center">Gene</th>
<th valign="top" align="center">Forward primer 5&#x2032;-3&#x2032;</th>
<th valign="top" align="center">Reverse primer 5&#x2032;-3&#x2032;</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center">TNF-&#x3b1;</td>
<td valign="top" align="center">CTCATGCACCACCACCAAGGACTC</td>
<td valign="top" align="center">AGACAGAGGCAACCCGACCACTC</td>
</tr>
<tr>
<td valign="top" align="center">TGF-&#x3b2;</td>
<td valign="top" align="center">GCAACAATTCCTGGCGTTACCTTG</td>
<td valign="top" align="center">CAGCCACTGCCGTACAACTCC</td>
</tr>
<tr>
<td valign="top" align="center">IL-12</td>
<td valign="top" align="center">CCTGTGACACGCCTGAAGAAGATG</td>
<td valign="top" align="center">CTTGTGGAGCAGCAGATGTGAGTG</td>
</tr>
<tr>
<td valign="top" align="center">IL-10</td>
<td valign="top" align="center">CTGCTATGCTGCCTGCTCTTACTG</td>
<td valign="top" align="center">ATGTGGCTCTGGCCGACTGG</td>
</tr>
<tr>
<td valign="top" align="center">iNOS</td>
<td valign="top" align="center">TGCCACGGACGAGACGGATAG</td>
<td valign="top" align="center">CTCTTCAAGCACCTCCAGGAACG</td>
</tr>
<tr>
<td valign="top" align="center">Arg-1</td>
<td valign="top" align="center">TGCTCACACTGACATCAACACTCC</td>
<td valign="top" align="center">GGTCTACGTCTCGCAAGCCAATG</td>
</tr>
<tr>
<td valign="top" align="center">&#x3b2;-actin</td>
<td valign="top" align="center">GTGCTATGTTGCTCTAGACTTCG</td>
<td valign="top" align="center">ATGCCACAGGATTCCATACC</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>Enzyme-linked immunosorbent assay</title>
<p>Groups were set according to different experimental purposes (control, CAL27-CM, R-RES, GS-9937, and RES). RES interfered with TAM polarization in two ways. R-RES refers to RES used for reprogramming TAMs. RAW264.7 cells were seeded in six-well plates, and the interventions were as follows. Control: normal complete medium was added. CAL27-CM: CAL27-CM was added to induce for 24 h. R-RES: cells were induced with CAL27-CM for 24 h and then replaced with 20 &#x3bc;M RES. GS-9937: 1 &#x3bc;M GS-9937 was added, and cells were induced with GS-9937-containing CAL27-CM for 24 h, then replaced with fresh medium. RES: cells were induced with CAL-CM containing 20 &#x3bc;M RES for 24 h, after which the medium was replaced with fresh medium. After 24 h, supernatants were collected to measure IL-10 and TNF-&#x3b1; levels using an enzyme immunoassay kit (CUSABIO, China) according to the manufacturer&#x2019;s instructions.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Immunofluorescence staining</title>
<p>After fixation with 4% PFA, TAMs were blocked with 5% BSA (Solarbio, China). CD86 and CD206 antibodies (Thermo Fisher, Massachusetts, USA) were added and incubated overnight at 4&#xb0;C. A red fluorescent secondary antibody (Thermo Fisher, Massachusetts, USA) was applied incubated in the dark for 1 h. Cells were washed with PBS and stained with DAPI (Thermo Fisher, Massachusetts, USA) for 2 min in the dark. Images were captured using an IX-71 fluorescence microscope (Olympus, Japan).</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Transwell assay</title>
<p>RAW264.7 cells (1 &#xd7; 10<sup>5</sup>/well) were seeded into 24-well 8.0 &#x3bc;m pore size inserts (Corning, USA). After different treatments, CAL27 cells (2 &#xd7; 10<sup>4</sup>) were seeded into 24-well BioCoat Matrigel invasion chambers (Corning, USA), with Matrigel pre-coated in advance for the invasion test. After 24 h (migration) or 48 h (invasion), CAL27 cells were fixed, stained with crystal violet, and photographed under a microscope. Experimental results were quantified and analyzed using Image J.</p>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Wound-healing assay</title>
<p>A wound healing culture insert (IBIDI, Germany) was placed into a six-well plate with 1 &#xd7; 10<sup>4</sup> CAL27 cells per insert. After cell attachment, the insert was removed. After washing with PBS, TAMs-CM was added and incubated for 24 h. Scratch closure at 0 h and 24 h was recorded using a microscope (Olympus, Japan).</p>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>Survival analysis</title>
<p>The OncoLnc tool (<ext-link ext-link-type="uri" xlink:href="https://www.oncolnc.org">www.oncolnc.org</ext-link>) was used to perform overall survival analysis for patients with head and neck squamous cell carcinoma (HNSCC). The 50th (upper) and 50th (lower) percentiles were considered as Syk-high and Syk-low groups. All HNSCC data were obtained from TCGA. Using these data, the association between Syk expression and survival time in patients with HNSCC was analyzed.</p>
</sec>
<sec id="s2_10">
<label>2.10</label>
<title>Western blotting</title>
<p>Total proteins from TAMs after RES intervention were extracted with RIPA lysis buffer (P0013B) containing PMSF (ST505) and phosphatase inhibitor cocktail A (P1081) (all from Beyotime, China). Proteins were separated by 10% sodium dodecyl sulfate&#x2013;polyacrylamide gel electrophoresis and transferred to a PVDF membrane (Bio-Rad, California, USA). After blocking with 5% nonfat milk, membrane-bound proteins were probed overnight at 4&#xb0;C with primary antibodies (1:1,000) against Syk (CST, Massachusetts, USA), p-Syk (CST, Massachusetts, USA), and &#x3b2;-actin (CST, Massachusetts, USA), followed by incubation for 1 h at room temperature with secondary antibodies (1:2,000; CST, Massachusetts, USA). Antibody-bound protein bands were detected using enhanced chemiluminescence reagents (Bio-Rad, California, USA) and visualized with an automatic chemiluminescence/fluorescence imaging system (Tanon, China). Data were analyzed using Image J.</p>
</sec>
<sec id="s2_11">
<label>2.11</label>
<title>Statistical analysis</title>
<p>Data analysis was performed using GraphPad Prism 8. Each experiment was repeated three times. Data are presented as mean &#xb1; SD (n = 3). For normally distributed data, t-test was used to compare two groups, and a one-way ANOVA was used to compare multiple groups. A <italic>P</italic>-value&#x2009;&lt;0.05 after correction was considered statistically significant. *<italic>P &lt;</italic>0.05; **<italic>P &lt;</italic>0.01; ***<italic>P &lt;</italic>0.001; **** <italic>P &lt;</italic>0.0001.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>CAL27-CM induced M2 polarization of TAMs</title>
<p>We used CAL27-CM to induce RAW264.7 cells for 24 h and validate the phenotype of the obtained TAMs. The morphological features of macrophages and TAMs were observed using light microscopy. TAMs were larger, exhibited more pseudopods, and displayed a more dispersed morphology than macrophages, which grew in circular aggregates (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). We verified the expression of the M2 TAMs surface marker CD206. The results showed that CD206 fluorescence intensity was significantly increased (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>). RT-qPCR results indicated that expression of the M2 marker cytokines IL-10 and Arg-1 mRNA was upregulated in TAMs treated with CAL27-CM in a time-dependent manner, peaking at 24 h and showing a slight decrease at 48 h (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1C, D</bold>
</xref>). TGF-&#x3b2; mRNA expression was also significantly upregulated at 24 h compared with other time points (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1E</bold>
</xref>). Compared with the control group, IL-10 protein secretion in the CAL27-CM group was significantly increased (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1F</bold>
</xref>). These results indicate that 24 h of CAL27-CM treatment induced macrophages into M2-type TAMs.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>CAL27-CM induced M2 polarization of TAMs. <bold>(A)</bold> Morphological manifestation of TAMs. Macrophages were treated with or without CAL27-CM for 24 h, and then observed under light microscope. <bold>(B)</bold> Immunofluorescence detection of CD206 in TAMs. Macrophages were treated with or without CAL27-CM for 24 h, and then observed under fluorescence microscope. <bold>(C&#x2013;E)</bold> mRNA expression of IL-10 <bold>(C)</bold>, Arg-1 <bold>(D)</bold>, and TGF-&#x3b2; <bold>(E)</bold> in macrophages treated with CAL27-CM at different time points. <bold>(F)</bold> IL-10 secretion of macrophages treated with CAL27-CM for 24 h. <bold>(G, H)</bold> Cells viability of macrophages and TAMs. Macrophages <bold>(G)</bold> and CAL27-CM-induced TAMs <bold>(H)</bold> were treated with different concentrations of RES (0 &#x3bc;M, 2.5 &#x3bc;M, 5 &#x3bc;M, 10 &#x3bc;M, 20 &#x3bc;M, 40 &#x3bc;M) for 24 h, and the cell viability was detected by CCK-8 assay. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by one-way analysis of variance (ANOVA). (<sup>*</sup>
<italic>P &lt;0.05</italic>; <italic>
<sup>**</sup>P &lt;0.01</italic>; <italic>
<sup>***</sup>P &lt;0.001</italic>; <italic>
<sup>****</sup>P &lt;0.0001</italic>; <italic>ns, P &gt;0.05</italic>). Scale bar: 50 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g001.tif">
<alt-text content-type="machine-generated">Panel A shows brightfield images of cell morphology under control and CAL27-CM conditions. Panel B displays immunofluorescence images with CD206 in red, DAPI in blue, and their merged view. Panels C, D, and E are bar graphs showing relative mRNA levels of IL-10, Arg-1, and TGF-&#x3b2; at different time points, with significant differences indicated. Panel F presents a bar graph comparing IL-10 protein levels in control and CAL27-CM conditions. Panels G and H depict cell viability percentages with varying concentrations, highlighting statistically significant changes.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>R-RES and RES inhibited invasion and migration of CAL27 cells through TAMs</title>
<p>First, the optimal concentration of RES was determined by assessing its impact on TAM cell activity. This was achieved using the CCK-8 method, which examined the effects of varying RES concentrations with CAL27-CM (0 &#x3bc;M, 2.5 &#x3bc;M, 5 &#x3bc;M, 10 &#x3bc;M, 20 &#x3bc;M, and 40 &#x3bc;M). The findings showed that the cell survival rate of macrophages (RAW264.7) (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1G</bold>
</xref>) and TAMs (CAL27-CM induced RAW264.7 for 24 h) (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1H</bold>
</xref>) remained above 80% with RES concentrations up to 20 &#xb5;M, whereas cell activity was significantly reduced at 40 &#xb5;M. These results demonstrated that RES concentrations up to 20 &#xb5;M were safe in this system, and thus the 20 &#xb5;M was selected for subsequent experiments.</p>
<p>To determine whether RES can influence the invasion and migration of CAL27 cells through TAMs, RES was applied to interfere with TAM polarization in two ways. R-RES refers to RES used for reprogramming TAMs. R-RES group: 20 &#x3bc;M RES was added to TAMs for 24 h. After replacement with complete medium and an additional 24 h of incubation, the TAM supernatant was collected for treatment of CAL27 cells. The Transwell assay results showed that the number of CAL27 cells invading and migrating was substantially decreased in the R-RES group compared with the control group (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2A, B, D, E</bold>
</xref>). The wound-healing assay showed that the migration capacity of CAL27 cells in the R-RES group was considerably reduced compared with the control group (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2C, F</bold>
</xref>). To investigate whether RES modulates OSCC cell invasion and migration by regulating macrophage polarization, RAW264.7 cells were cultured with 20 &#x3bc;M RES and CAL27 cell culture medium (CAL27-CM) for 24 h. The medium was then substituted with complete medium. After 24 h of incubation, TAM supernatant was collected for treatment of CAL27 cells. Transwell and wound-healing assays showed that the ability of CAL27 cells to invade and migrate was significantly reduced in the RES group compared with the control group (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2G&#x2013;L</bold>
</xref>). The results indicated that RES inhibited the invasion and migration of CAL27 cells by modulating the differentiation of macrophages into TAMs.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>R-RES and RES inhibits invasion and migration of CAL27 cells through TAMs. R-RES group: CAL27-CM was induced for 24 h and then replaced with 20 &#x3bc;M RES <bold>(A&#x2013;F)</bold>, RES group: 24 h of induction with CAL-CM containing 20 &#x3bc;M RES <bold>(G&#x2013;L)</bold>. Transwell invasion assay to detect the invasive ability of CAL27 cells <bold>(A, G)</bold> and statistical analysis of the number of invasive cells in each group <bold>(D, J)</bold>. Transwell migration assay was used to detect the migration ability of CAL27 cells <bold>(B, H)</bold> and the statistical analysis of the number of migration cells in each group <bold>(E, K)</bold>. Wound healing assay was used to detect the migration ability of CAL27 cells <bold>(C, I)</bold> and statistical analysis of cell migration rate <bold>(F, L)</bold>. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. (<italic>
<sup>**</sup>P &lt;0.01, <sup>***</sup>P &lt;0.001</italic>). Scale bar: 200 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g002.tif">
<alt-text content-type="machine-generated">Microscopic images and graphs show the effects of R-RES on cell invasion and migration compared to control. Panels A, B, G, and H depict stained cells, with fewer cells in R-RES conditions. Panels C and I display wound healing assays at 0 and 24 hours showing inhibited cell migration under R-RES. Graphs D, E, F, J, K, and L quantify these results, highlighting significantly reduced invasion and migration in R-RES-treated groups. Statistical significance is marked with asterisks.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>R-RES reprogrammed TAMs from M2 to M1 phenotype</title>
<p>To further elucidate the underlying mechanisms, we investigated whether this inhibitory effect of R-RES on the invasion and migration of CAL27 cells was attributable to an altered TAM phenotype. RT-qPCR results indicated that the mRNA levels of the M1 marker cytokines TNF-&#x3b1; and IL-12 were significantly higher, and those of iNOS were slightly higher, in the R-RES group compared with the control group (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3A&#x2013;C</bold>
</xref>). Conversely, the mRNA levels of the M2 marker cytokines TGF-&#x3b2;, IL-10, and Arg-1 were significantly reduced (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3E&#x2013;G</bold>
</xref>). ELISA results showed that the alterations in TNF-&#x3b1; and IL-10 protein secretion levels were consistent with their gene expression levels (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3D, H</bold>
</xref>). Immunofluorescence staining showed that the fluorescence intensity of the M2 surface marker CD206 was significantly reduced, while that of the M1 surface marker CD86 was enhanced, in the R-RES group compared to the control group (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3I, J</bold>
</xref>). These results indicate that R-RES can reprogram TAMs from the M2 to the M1 phenotype.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>R-RES reprograms TAMs from M2 to M1 phenotype. R-RES group: CAL27-CM was induced for 24 h and then replaced with 20 &#x3bc;M. <bold>(A&#x2013;E)</bold> Detection of TNF-&#x3b1; <bold>(A)</bold>, IL-12 <bold>(B)</bold>, iNOS <bold>(C)</bold>, TGF-&#x3b2; <bold>(E)</bold>, IL-10 <bold>(F)</bold> and Arg-1 <bold>(G)</bold> mRNA levels in TAMs by RT-qPCR assay <bold>(D, H)</bold> ELISA assay to detect TNF-&#x3b1; <bold>(D)</bold> and IL-10 <bold>(H)</bold> secretion levels in TAMs. <bold>(I, J)</bold> Detection of CD86 <bold>(I)</bold> and CD206 <bold>(J)</bold> expression on the surface of TAMs by immunofluorescence assay. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. <italic>(<sup>**</sup>P &lt;0.01</italic>; <italic>
<sup>***</sup>P &lt;0.001</italic>; <italic>ns, P &gt;0.05).</italic> Scale bar: 50 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g003.tif">
<alt-text content-type="machine-generated">Graphs A to H display the effects of R-RES on various mRNA and protein levels, such as TNF-&#x3b1;, IL-12, iNOS, and IL-10, in comparison to the control. Significant increases or decreases are noted with ** or ***. Images I and J show immunofluorescence staining for CD86 and CD206 with DAPI-stained nuclei in control and R-RES treated samples. The merged images show localization of the markers in the cells. Scale bars are present in the merged images.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>RES facilitated M1 polarization of TAMs and suppressed their M2 polarization</title>
<p>The subsequent investigation aimed to ascertain whether RES can also influence the polarization phenotype of TAMs. The polarization phenotype of TAMs was assessed by inducing RAW264.7 cells with CAL27-CM containing RES for 24 h. RT-qPCR results showed that the expression levels of TNF-&#x3b1;, IL-12, and iNOS mRNA in TAMs were considerably higher in the RES group than in the control group (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A&#x2013;C</bold>
</xref>), while the levels of TGF-&#x3b2;, IL-10, and Arg-1 mRNA were markedly decreased in the RES group compared with the control group (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4E&#x2013;G</bold>
</xref>). ELISA results indicated that the secretion level of TNF-&#x3b1; was significantly higher (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4D</bold>
</xref>), while the secretion level of IL-10 was lower (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4H</bold>
</xref>) in the RES group compared with the control group. Immunofluorescence staining results showed that surface CD86 expression in TAMs (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4I</bold>
</xref>) was enhanced, while CD206 expression (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4J</bold>
</xref>) was reduced in the RES group compared with the control group. These results demonstrate that RES promotes M1 polarization of TAMs and suppresses their M2 polarization.</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>RES promotes M1 polarization of TAMs and inhibits M2 polarization of TAMs. RES group: 24 h of induction with CAL-CM containing 20 &#x3bc;M RES. <bold>(A&#x2013;F)</bold> Detection of TNF-&#x3b1; <bold>(A)</bold>, IL-12 <bold>(B)</bold>, iNOS <bold>(C)</bold>, TGF-&#x3b2; <bold>(D)</bold>, IL-10 <bold>(E)</bold> and Arg-1 <bold>(F)</bold> mRNA levels in TAMs by RT-qPCR assay <bold>(G, H)</bold> ELISA assay to detect TNF-&#x3b1; <bold>(G)</bold> and IL-10 <bold>(H)</bold> secretion levels in TAMs. <bold>(I, J)</bold> Detection of CD206 <bold>(I)</bold> and CD86 <bold>(J)</bold> expression on the surface of TAMs by immunofluorescence assay. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. <italic>(<sup>*</sup>P &lt;</italic>0.05; <sup>**</sup>
<italic>P &lt;</italic>0.01; <sup>***</sup>
<italic>P &lt;</italic>0.001; <sup>****</sup>
<italic>P &lt;</italic>0.0001<italic>).</italic> Scale bar: 50 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g004.tif">
<alt-text content-type="machine-generated">Bar charts show mRNA and protein levels in Control vs. RES groups for various markers. Panels A-G depict differences in mRNA levels of TNF-&#x3b1;, IL-12, iNOS, TGF-&#x3b2;, IL-10, and Arg-1, while panels D and H show protein levels for TNF-&#x3b1; and IL-10. Asterisks denote statistical significance. Below, immunofluorescence images (I, J) compare CD86 and CD206 expression in Control vs. RES groups, with DAPI staining nuclei. Merged images illustrate co-localization. Scale bars represent fifty micrometers.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>R-RES and RES inhibited activation of Syk signaling pathway in TAMs</title>
<p>The mechanisms by which RES regulates TAM polarization were further investigated. A total of 2,345 OSCC-related targets were identified using the GeneCards database, 59 RES-related target genes were obtained from the SwissTargetPrediction platform, and a &#x201c;RES-OSCC&#x201d; intersection target map was generated with the Bioinformatics &amp; Evolutionary Genomics network platform, yielding 41 target genes (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5A</bold>
</xref>). The STRING V11.0 was used to analyze the proteins among the 41 intersection targets and to construct the protein&#x2013;protein interaction network (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5B</bold>
</xref>). In the figure, nodes represent proteins, and connecting lines illustrate their relationships. The top 20 key target proteins were identified based on degree value, including spleen tyrosine kinase (Syk) (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5C</bold>
</xref>). To investigate the site of Syk expression in HNSCC tissues, a single-cell dataset (<xref ref-type="bibr" rid="B38">38</xref>; <ext-link ext-link-type="uri" xlink:href="https://www.weizmann.ac.il/sites/3CA/">https://www.weizmann.ac.il/sites/3CA/</ext-link>) was used for further analysis (<xref ref-type="bibr" rid="B38">38</xref>). UMAP analysis was conducted to reduce the dimensionality and cluster the cells into nine cell populations (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5D</bold>
</xref>). Syk expression was highest in macrophages (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5E</bold>
</xref>). In addition, analysis of The Cancer Genome Atlas (TCGA) database showed that Syk is highly expressed in HNSCC tumor tissues compared with normal tissues (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5F, G</bold>
</xref>). Using the TCGA database, we examined the correlation between Syk expression and overall survival in HNSCC patients (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5H</bold>
</xref>). In the correlation analysis, Syk showed a weak positive correlation with IL-10 (M2 TAM marker; <italic>R</italic> = 0.064, <italic>P</italic> &lt; 0.05) and TNF-&#x3b1; (M1 TAM marker; <italic>R</italic> = &#x2212;0.096, <italic>P &gt;</italic>0.05) (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5I, J</bold>
</xref>). We examined Syk protein levels and phosphorylation in TAMs after RES intervention by Western blot assay. The findings revealed no significant changes in total Syk protein levels and significantly lower p-Syk protein expression in the R-RES group compared with the control group (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5K&#x2013;M</bold>
</xref>), as well as no significant changes in total Syk protein levels and significantly lower p-Syk expression in the RES group compared with the control group (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5N&#x2013;P</bold>
</xref>). These results indicate that R-RES and RES inhibit Syk phosphorylation.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>R-RES and RES inhibit Syk phosphorylation in TAMs. R-RES group: CAL27-CM was induced for 24 h and then replaced with 20 &#x3bc;M RES <bold>(A&#x2013;F)</bold>, RES group: 24 h of induction with CAL-CM containing 20 &#x3bc;M RES. <bold>(A&#x2013;C)</bold> Wayne plots of targets related to OSCC and RES <bold>(A)</bold>, Protein-protein interaction map of the common targets of OSCC and RES <bold>(B)</bold>, and the top 20 key targets screened by Cytoscape software <bold>(C)</bold>. <bold>(D, E)</bold> UMAP plot showing the cell clusters in the TME and the expression patterns of Syk in different cell types were analyzed using single-cell RNA sequencing data. <bold>(F&#x2013;G)</bold> The differential expression between tumor and adjacent normal tissues for Syk across all TCGA tumors. <bold>(H)</bold> Correlation between Syk expression levels and overall survival in patients with HNSCC. <bold>(I, J)</bold> In HNSCC tumor, the expression level of Syk correlates with TNF (TNF-&#x3b1;) <bold>(I)</bold> and IL-10 <bold>(J)</bold> were analyzed by GEPIA (<italic>Pearson</italic> correlation was selected). <bold>(K&#x2013;P)</bold> Statistical analysis of protein expression and relative protein expression of Syk and p-Syk in R-RES <bold>(K&#x2013;M)</bold> and RES <bold>(N&#x2013;P)</bold> group TAMs. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. (*<italic>P &lt;</italic>0.05; **<italic>P &lt;</italic>0.01).</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g005.tif">
<alt-text content-type="machine-generated">A composite of various scientific data visualizations and graphs detailing research findings. It includes a Venn diagram (A), network diagram (B), circular diagram (C), UMAP plots displaying cell types and STYK expression (D), expression box plots (E&#x2013;G), survival curve (H), scatterplots (I, J), Western blot bands with statistical bars for comparison (K&#x2013;P). Each visualization provides insights into different aspects of the study, such as gene expression, protein levels, and survival rates.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_6">
<label>3.6</label>
<title>Syk inhibitor facilitated M1 polarization of TAMs and suppressed their M2 polarization</title>
<p>GS-9937 is a selective Syk inhibitor currently under evaluation in phase II clinical trials for hematological malignancies. It has demonstrated a favorable <italic>in vitro</italic> and <italic>in vivo</italic> selectivity profile with fewer dose-limiting adverse effects (<xref ref-type="bibr" rid="B39">39</xref>). RAW264.7 cells were treated with CAL27-CM containing the Syk inhibitor GS-9937 for 24 h to assess the polarization phenotype of TAMs. RT-qPCR showed that the expression levels of TNF-&#x3b1;, IL-12, and iNOS mRNA in TAMs were significantly increased in the GS-9937 group compared with the control group (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6A&#x2013;C</bold>
</xref>). There was no significant difference in TGF-&#x3b2; mRNA expression between the two groups (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6E</bold>
</xref>). IL-10 and Arg-1 mRNA levels were significantly lower in the GS-9937 group compared with the control group (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6F, G</bold>
</xref>). ELISA results showed that TNF-&#x3b1; secretion level was significantly enhanced (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6D</bold>
</xref>), while IL-10 secretion was decreased (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6H</bold>
</xref>) in the GS-9937 group compared with the control group. Immunofluorescence staining indicated that surface CD206 expression in TAMs was diminished, whereas CD86 expression was enhanced in the GS-9937 group compared with the control group (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6I, J</bold>
</xref>). These results indicate that inhibition of the Syk signaling pathway in TAMs promoted M1 polarization and suppressed M2 polarization.</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>Syk inhibitor promotes M1 polarization of TAMs and inhibits M2 polarization of TAMs. GS-9937 (1 &#x3bc;M) was used to inhibit the activation of Syk pathway in TAMs. (<bold>A&#x2013;C, E&#x2013;G</bold>) RT-qPCR assay to detect TNF-&#x3b1; <bold>(A)</bold>, IL-12 <bold>(B)</bold>, iNOS <bold>(C)</bold>, TGF-&#x3b2; <bold>(E)</bold>, IL-10 <bold>(F)</bold> and Arg-1 <bold>(G)</bold> mRNA levels in TAMs. <bold>(D, H)</bold> ELISA assay to detect TNF-&#x3b1; <bold>(D)</bold> and IL-10 <bold>(H)</bold> secretion levels in TAMs. <bold>(I, J)</bold> Detection of CD86 <bold>(I)</bold> and CD206 <bold>(J)</bold> expression on the surface of TAMs by immunofluorescence assay. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. (*<italic>P &lt;</italic>0.05; **<italic>P &lt;</italic>0.01; ***<italic>P &lt;</italic>0.001; ns, <italic>P &gt;</italic>0.05). Scale bar: 50 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g006.tif">
<alt-text content-type="machine-generated">Bar graphs and immunofluorescence images compare control and GS-9937 treated samples. Charts (A-H) show mRNA and protein levels of TNF-&#x3b1;, IL-12, iNOS, TGF-&#x3b2;, IL-10, and Arg-1, with significant changes noted. Immunofluorescence images (I, J) display CD86 and CD206 expression with DAPI-stained nuclei.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_7">
<label>3.7</label>
<title>Syk inhibitor attenuated invasive and migratory ability of CAL27 cells</title>
<p>We next verified whether the inhibition of the Syk signaling pathway in TAMs attenuated the invasion and migration of CAL27 cells. TAMs were treated with GS-9937. The results of Transwell assay revealed a significant reduction in the number of CAL27 cells that invaded and migrated in the GS-9937 group compared with the control group (<xref ref-type="fig" rid="f7">
<bold>Figures&#xa0;7A, B, D, E</bold>
</xref>). The wound-healing assay demonstrated that the migration ability of CAL27 cells in the GS-9937 group was markedly reduced compared with the control group (<xref ref-type="fig" rid="f7">
<bold>Figures&#xa0;7C, F</bold>
</xref>). These results indicate that the invasion and migration ability of CAL27 cells can be diminished by inhibiting the Syk signaling pathway in TAMs.</p>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>Syk inhibitor attenuates invasive and migratory ability of CAL27 cells. <bold>(A, D)</bold> Transwell assay to detect the number of invasive cells in each group of CAL27 cells and statistical analysis. <bold>(B, E)</bold> Transwell assay to detect the number of migrating cells in each group of CAL27 cells and statistical analysis. <bold>(C, F)</bold> Cell scratch assay to detect the migration ability of CAL27 cells in each group and statistical analysis. Data are presented as the mean &#xb1; SD (n = 3). P-values were determined by t-test. (***<italic>P &lt;</italic>0.001; ****<italic>P &lt;</italic>0.001). Scale bar: 200 &#x3bc;m.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1660851-g007.tif">
<alt-text content-type="machine-generated">Panels A and B show stained cell images comparing control and GS-9937 treatments, with fewer cells visible in the GS-9937 condition. Panel C shows side-by-side wound healing images at 0 and 24 hours, with less cell migration in the GS-9937-treated section. Panels D, E, and F present bar graphs quantifying invasion, migration cell number, and migration percentage, all significantly reduced in the GS-9937 condition compared to control.</alt-text>
</graphic>
</fig>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>Plant extracts can exert anti-tumor effects by regulating the polarization phenotype of TAMs (<xref ref-type="bibr" rid="B18">18</xref>&#x2013;<xref ref-type="bibr" rid="B20">20</xref>). In this study, we found that CAL27-CM induced M2 polarization of TAMs. R-RES and RES inhibited the invasion and migration of CAL27 cells through TAMs. R-RES reprogrammed TAMs from the M2 to the M1 phenotype. RES facilitated M1 polarization of TAMs and suppressed their M2 polarization. Mechanistically, R-RES and RES inhibited the activation of the Syk signaling pathway in TAMs. Inhibition of the Syk signaling pathway in TAMs attenuated the invasive and migratory ability of CAL27 cells by facilitating M1 polarization and suppressing M2 polarization.</p>
<p>The polarization of TAMs can be induced by the CM of OSCC cells or by a co-culture system (<xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B40">40</xref>). The co-culture system is favored because OSCC cells continuously secrete mediators that induce the polarization of TAMs (<xref ref-type="bibr" rid="B20">20</xref>, <xref ref-type="bibr" rid="B41">41</xref>). However, the influence of drug-regulated OSCC cells on TAMs is inevitable when continuous drug intervention targeting TAMs is applied during the co-culture period. In contrast, TAM polarization induced by OSCC cell CM can effectively address this drawback. Therefore, CAL27-CM was used to induce TAM polarization in this study. We found that CAL27-CM induced M2 polarization of TAMs, further confirming previous studies (<xref ref-type="bibr" rid="B12">12</xref>, <xref ref-type="bibr" rid="B42">42</xref>).</p>
<p>RES has been shown to suppress OSCC invasion and migration through different mechanisms (<xref ref-type="bibr" rid="B27">27</xref>&#x2013;<xref ref-type="bibr" rid="B29">29</xref>). However, studies on RES intervention in OSCC invasion and migration have focused on its direct effects on OSCC cells, with little attention to its indirect effect through TAMs. In this study, RES modulated the polarization of TAMs in two ways to examine whether it could influence OSCC invasion and migration through TAMs. R-RES was added after 24 h induction of macrophages with the CAL27-CM. RES and CAL27-CM were added simultaneously to observe changes in polarization phenotype of TAMs. Our results showed that R-RES and RES inhibited the invasion and migration of CAL27 cells by regulating TAM polarization.</p>
<p>RES could reprogram M2 TAMs to the M1 phenotype in a tumor model of lung adenocarcinoma (<xref ref-type="bibr" rid="B4">4</xref>). RES reversed macrophage polarization and increased the M1/M2 polarization ratio in breast cancer (<xref ref-type="bibr" rid="B32">32</xref>). RES can convert macrophages to the M1 phenotype in the lungs of TNBC-bearing mice (<xref ref-type="bibr" rid="B43">43</xref>). The ethanol extract of peanut sprout tea containing RES suppressed the interaction between breast cancer cells and TAMs, promoting M1 TAMs while inhibiting M2 TAMs (<xref ref-type="bibr" rid="B44">44</xref>). However, the effects of RES on TAM polarization in OSCC have been rarely reported. In this study, RES regulated TAM polarization through a dual pathway. R-RES reprogrammed TAMs from the M2 to the M1 phenotype. RES facilitated M1 polarization of TAMs while suppressing their M2 polarization. These results are consistent with previous studies, further highlighting the impact of RES on tumor immunology.</p>
<p>Inflammation-related studies have revealed the signaling pathways through which RES regulates macrophage polarization (<xref ref-type="bibr" rid="B45">45</xref>). RES might promote M2 polarization of macrophages after myocardial infarction via the JAK2/STAT3 signaling pathway (<xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B47">47</xref>). RES can regulate macrophage polarization via the TLR4/MyD88 signaling pathway (<xref ref-type="bibr" rid="B48">48</xref>). Polydatin, a glucoside of resveratrol, remodels macrophage polarization via the NF-&#x3ba;B signaling pathway (<xref ref-type="bibr" rid="B49">49</xref>). A resveratrol-mediated hydrogel can modulate macrophage polarization via the PI3K/AKT signaling pathway (<xref ref-type="bibr" rid="B50">50</xref>, <xref ref-type="bibr" rid="B51">51</xref>). Few reports have evaluated the signaling pathway in TAMs regarding the mechanism by which RES regulates TAM polarization.</p>
<p>Syk is a non-receptor tyrosine kinase involved in cancer progression (<xref ref-type="bibr" rid="B52">52</xref>, <xref ref-type="bibr" rid="B53">53</xref>). RES has been reported to inhibit Syk phosphorylation in monocytes/macrophages during inflammation. RES suppresses monosodium urate-induced inflammation by inhibiting Syk phosphorylation in monocytes (<xref ref-type="bibr" rid="B54">54</xref>). Amurensin H, a RES dimer, alleviates LPS-induced inflammation by inhibiting the Syk/NF-&#x3ba;B pathway in macrophages (<xref ref-type="bibr" rid="B55">55</xref>). However, the regulation of Syk activation by RES has not been reported in TAMs. In this study, bioinformatics analysis showed that Syk was among the top 20 key target proteins of OSCC and RES. UMAP and TCGA database analyses further revealed that Syk was predominantly expressed in macrophages of HNSCC. These results suggested that Syk may be involved in the regulation of TAM polarization by RES. We then verified whether RES regulated the Syk signaling pathway in TAMs. The results showed that R-RES and RES suppressed the activation of Syk signaling pathway in TAMs. Intervention experiments with Syk inhibitors further demonstrated that inhibiting the Syk signaling pathway in TAMs attenuated the invasive and migratory abilities of CAL27 cells by facilitating M1 polarization of TAMs and suppressing their M2 polarization. Targeting Syk in TAMs may represent a promising treatment strategy for cancers.</p>
<p>Subsequent experiments will focus on identifying the upstream receptors and downstream signaling pathways through which RES exerts its effects on TAMs. Toll-like receptors (TLRs) are pathogen recognition receptor that trigger intracellular signaling cascades in response to pathogens, leading to the secretion of interferons and proinflammatory cytokines and the activation of host defense programs necessary for innate or adaptive immune responses (<xref ref-type="bibr" rid="B56">56</xref>). TLR4 is one of the most widely studied TLRs in the tumor microenvironment and plays a key role in immune surveillance and tumor progression (<xref ref-type="bibr" rid="B57">57</xref>, <xref ref-type="bibr" rid="B58">58</xref>). Our previous results showed that ENO1 and HSP27 regulate TAM polarization and cytokine secretion through the TLR4 on the surface of TAMs (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B12">12</xref>). Several studies have reported that RES regulates the expression of TLR4 and Syk is recruited to the TLR4-related receptor complex (<xref ref-type="bibr" rid="B59">59</xref>, <xref ref-type="bibr" rid="B60">60</xref>). RES suppressed MMP3 and MMP9 expression and secretion by inhibiting the TLR4/Syk/NLRP3 inflammasome pathway in platelets (<xref ref-type="bibr" rid="B61">61</xref>). STRING database analysis confirmed the association of TLR4 and Syk (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1A</bold>
</xref>). TCGA database analysis showed a positive association between TLR4 and Syk (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1B</bold>
</xref>). In this study, RES may regulate TAM repolarization through TLR4.</p>
<p>Amurensin H exerts anti-inflammatory and chondroprotective effects <italic>in vivo</italic> and <italic>in vitro</italic> and inhibits TLR4/Syk/NF-&#x3ba;B signaling in chondrocytes (<xref ref-type="bibr" rid="B62">62</xref>). In human proximal tubular epithelial cells, high glucose triggers the immediate, ROS-dependent release of HMGB-1 into the extracellular space, thereby activating the TLR4/MyD88/Syk/NF-&#x3ba;B pathway (<xref ref-type="bibr" rid="B63">63</xref>). Key molecules in TLR4 downstream signaling in mice with retinal ischemia/reperfusion injury are Syk and NF-&#x3ba;B (<xref ref-type="bibr" rid="B64">64</xref>). TREM1 enhances microglial plasticity through the Syk/PDK/STAT3 signaling axis, thereby promoting an immune environment favorable to tumor progression (<xref ref-type="bibr" rid="B65">65</xref>). RES suppressed MMP3 and MMP9 expression and secretion by inhibiting the TLR4/Syk/NLRP3 inflammasome pathway in platelets (<xref ref-type="bibr" rid="B61">61</xref>). STRING database analysis confirmed the association of Syk/NF-&#x3ba;B, Syk/STAT3, and Syk/NLRP3 (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1A</bold>
</xref>). The results of TCGA database showed the positive association of Syk/NF-&#x3ba;B and Syk/STAT3 (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figures S1C&#x2013;E</bold>
</xref>). We speculate that RES may regulate TAM polarization through TLR4/Syk/NF-&#x3ba;B or TLR4/Syk/STAT3 signaling pathways in OSCC (<xref ref-type="bibr" rid="B66">66</xref>).</p>
<p>Although RES targets multiple pathways, its rapid metabolism and low oral bioavailability restrict its clinical application. To overcome these disadvantages, RES has been encapsulated in various nanocarriers, including liposomes, polymeric nanoparticles, solid lipid nanoparticles (SLNs), protein-based nanoparticles, and inorganic nanoparticles. These can modulate the release of the drug to achieve the desired effect. Significant therapeutic concentrations have been demonstrated in plasma, with improved bioavailability (<xref ref-type="bibr" rid="B67">67</xref>). Polymer nanoparticles are the most widely used among these nanocarriers due to their high encapsulation efficiency. This significantly reduces the number of nanocarriers required to achieve the desired bioactivity, while also reducing the risk of toxicity and side effects (<xref ref-type="bibr" rid="B68">68</xref>). Literature indicates that Ancic et&#xa0;al. conducted a study investigating the use of resveratrol nanoparticles as an anti-tumor agent in mice with Ehrlich ascites tumor (EAT) (<xref ref-type="bibr" rid="B69">69</xref>). It is necessary to incorporate preliminary pharmacokinetic and toxicity evaluations, and to explore nano-formulation and targeted delivery strategies for improving translational prospects.</p>
<p>Moreover, during the early tumorigenesis process, M2 TAMs can significantly promote the tumor survival, growth, and metastasis by causing immunosuppression of CD8+ T cells and creating a tumor-favorable microenvironment (<xref ref-type="bibr" rid="B70">70</xref>). M2 TAMs, together with regulatory T cells (T-regs), are reprogrammed to become immunosuppressive. This results in the inactivation or impaired recruitment of cytotoxic CD8 + T and Natural Killer (NK) cells (<xref ref-type="bibr" rid="B71">71</xref>). M2-like macrophages drive tumor growth both directly and indirectly by suppressing cytotoxic cell populations, including CD8+ T cells and NK cells (<xref ref-type="bibr" rid="B72">72</xref>). Previous research indicated that RES improved CD8+ T cell cytotoxicity by increasing TNF-&#x3b1;, IFN-&#x3b3;, IL-12, and IL-2 (<xref ref-type="bibr" rid="B73">73</xref>). Consequently, we hypothesize that the reduction of RES-induced M2-phenotype TAMs may be associated with CD8+ T cells. This hypothesis will be tested in future experimental research.</p>
<p>The anti-tumor and pro-tumor phenotypes of TAMs make them a double-edged sword in OSCC progression, while their phenotypic plasticity also makes them important potential therapeutic targets. We found that RES suppressed OSCC invasion and migration through CAL27-CM-induced TAMs. Mechanistically, RES reprogrammed TAMs from a pro-tumor to an anti-tumor phenotype and promoted macrophage polarization toward the anti-tumor phenotype by inhibiting the activation of the Syk signaling pathway. In conclusion, RES suppresses OSCC invasion and migration by regulating TAM polarization through the Syk signaling pathway, further elucidating its anti-tumor mechanism. Targeting Syk in TAMs may represent a promising therapeutic strategy for cancer. As a preliminary mechanistic study, the present study provides directions for future research. The regulatory effects of RES on TAM polarization and OSCC invasion and migration, along with the related upstream receptors and downstream signaling pathways, need to be further verified in human monocyte-derived macrophages (MDMs), primary TAMs isolated from OSCC patients, and murine xenograft models or spontaneous OSCC models. Nanoformulated RES (<xref ref-type="bibr" rid="B74">74</xref>, <xref ref-type="bibr" rid="B75">75</xref>) and RES-loaded nanocarriers (<xref ref-type="bibr" rid="B76">76</xref>&#x2013;<xref ref-type="bibr" rid="B78">78</xref>) targeting TAMs may represent effective treatment strategies against OSCC progression.</p>
</sec>
</body>
<back>
<sec id="s5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Material</bold></xref>, further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s6" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>Ethical approval was not required for the studies on humans in accordance with the local legislation and institutional requirements because only commercially available established cell lines were used. Ethical approval was not required for the studies on animals in accordance with the local legislation and institutional requirements because only commercially available established cell lines were used.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author contributions</title>
<p>WL: Conceptualization, Data curation, Formal Analysis, Methodology, Writing &#x2013; original draft. YQ: Conceptualization, Data curation, Methodology, Writing &#x2013; review &amp; editing. YL: Data curation, Methodology, Writing &#x2013; review &amp; editing. LL: Data curation, Formal Analysis, Writing &#x2013; review &amp; editing. XD: Formal Analysis, Writing &#x2013; review &amp; editing. BL: Conceptualization, Writing &#x2013; review &amp; editing, Funding acquisition.</p>
</sec>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research and/or publication of this article. This research was funded by the Key Research and Development (International Science and Technology Cooperation) Project from Jilin Provincial Department of Science and Technology (20250205010GH).</p>
</sec>
<sec id="s9" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
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<title>Generative AI statement</title>
<p>The author(s) declare that no Generative AI was used in the creation of this manuscript.</p>
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<title>Publisher&#x2019;s note</title>
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<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fimmu.2025.1660851/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fimmu.2025.1660851/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="SupplementaryFile1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
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