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Intriguingly, non\u2010malignant lymphocytes or stromal cells such as tumor\u2010associated macrophages and cancer\u2010associated fibroblasts contribute to the lactate accumulation in the tumor environment, a phenomenon described as the \u201cReverse Warburg effect.\u201d Localized lactic acidosis has a strong immunosuppressive effect and mediates an immune escape of tumors. However, some tumors do not display the Warburg phenotype and either rely on respiration or appear as a mosaic of cells with different metabolic properties. Based on these findings and on the knowledge that T cell infiltration is predictive for patient outcome, we suggest a metabolic\u2010tumor\u2010stroma score to determine the likelihood of a successful anti\u2010tumor immune response: (a) a respiring tumor with high T cell infiltration (\u201chot\u201d); (b) a reverse Warburg type with respiring tumor cells but glycolytic stromal cells; (c) a mixed type with glycolytic and respiring compartments; and (d) a glycolytic (Warburg) tumor with low T cell infiltration (\u201ccold\u201d). Here, we provide evidence that these types can be independent of the organ of origin, prognostically relevant and might help select the appropriate immunotherapy approach.<\/jats:p>","DOI":"10.1111\/imr.12846","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T02:15:04Z","timestamp":1583892904000},"page":"187-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":110,"title":["The immunological Warburg effect: Can a metabolic\u2010tumor\u2010stroma score (MeTS) guide cancer immunotherapy?"],"prefix":"10.1111","volume":"295","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1521-6213","authenticated-orcid":false,"given":"Peter J.","family":"Siska","sequence":"first","affiliation":[{"name":"Internal Medicine III University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Singer","sequence":"additional","affiliation":[{"name":"Internal Medicine III University Hospital Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Evert","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7116-1368","authenticated-orcid":false,"given":"Kathrin","family":"Renner","sequence":"additional","affiliation":[{"name":"Internal Medicine III University Hospital Regensburg Regensburg Germany"},{"name":"Regensburg Center for Interventional Immunology (RCI) Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8762-9861","authenticated-orcid":false,"given":"Marina","family":"Kreutz","sequence":"additional","affiliation":[{"name":"Internal Medicine III University Hospital Regensburg Regensburg Germany"},{"name":"Regensburg Center for Interventional Immunology (RCI) Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"309","article-title":"Ueber den Stoffwechsel der Tumoren","volume":"152","author":"Warburg O","year":"1924","journal-title":"Biochem Z"},{"key":"e_1_2_10_3_1","first-page":"11","article-title":"The carbohydrate metabolism of tumors I. 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