Clonorchis sinensis co-infection potentiates polymorphonuclear-myeloid-derived suppressor cells expansion and metabolic reprogramming in chronic hepatitis B patients

Figure 7 Mediation analysis of the association between interleukin-6 and interferon-γ through polymorphonuclear myeloid-derived suppressor cells. The path model demonstrates that interleukin-6 (IL-6) promotes polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) expansion (a = 0.008, P < 0.001), and PMN-MDSCs in turn suppress interferon-γ (IFN-γ) (b = -0.507, P = 0.005). After adjusting for PMN-MDSCs, the direct effect of IL-6 on IFN-γ was attenuated and no longer significant (c’ = -0.005, P = 0.186), whereas the indirect effect via PMN-MDSCs remained significant. The total effect of IL-6 on IFN-γ was -0.009 (P = 0.017), with PMN-MDSCs mediating approximately 45% of this effect. IL-6: Interleukin-6; IFN-γ: Interferon-γ; PMN-MDSC: Polymorphonuclear myeloidderived suppressor cell.