{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:59:17Z","timestamp":1790600357455,"version":"4.1.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Immunotherapy responses in colorectal cancer peritoneal metastases (CRCPM) are not determined by mismatch repair (MMR) status alone. Most MMR-proficient\/microsatellite-stable (pMMR\/MSS) tumors have low baseline sensitivity, while MMR-deficient\/microsatellite instability-high (dMMR\/MSI-H) tumors do not respond uniformly, particularly in patients with ascites. This Mini Review compares evidence across compartments and disease stages: human associations, macrophage-resolved functional studies and interventions altering immunotherapy efficacy in mice. Human ascites and tissue studies identify resident-like and monocyte-associated macrophages, including C1Q\n                    <jats:sup>+<\/jats:sup>\n                    and SPP1\n                    <jats:sup>+<\/jats:sup>\n                    states, but shared markers do not establish equivalent functions or origins. During niche conditioning and early seeding, ABCA9-dependent cholesterol handling, tumor-derived lysophosphatidic acid signaling and TLR4\u2013CXCL10 activation can support local T-cell-mediated tumor control, although these studies did not test immune checkpoint blockade (ICB) or adoptive cell therapy (ACT). In established disease, SPP1-associated macrophage-intrinsic peroxisome proliferator-activated receptor-\u03b3 (PPAR\u03b3) programming and extracellular SPP1\u2013CD44 signaling restrain CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells, and SPP1 perturbation improves anti-PD-1 and ACT responses in mice. The relative contributions of these routes to treatment rescue remain unresolved. TIM-4 and MerTK provide distinct non-metabolic constraints. Human evidence for the resistance-associated SPP1 state remains cross-sectional. Lipid-related pathways in CRCPM models thus have opposing immune effects rather than acting as a single metabolic switch.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1974770","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:13:47Z","timestamp":1790597627000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Macrophage states and immunometabolic adaptation in peritoneal metastases from colorectal cancer"],"prefix":"10.3389","volume":"17","author":[{"given":"Weihao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Hospital of Zhenjiang Affiliated to Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Ye","sequence":"additional","affiliation":[{"name":"Medical School of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, 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