*2.4. Effect of OV on Tumor Vasculature*

Some OVs, such as HSVs and VACVs, can target tumor stromal cells, such as TAFs, vECs, and pericytes, thereby destroy the tumor's complex structure [26]. TGF-β secreted by tumor cells makes TAFs susceptible to OV infection [125]. OVs also reduce the fibrosis in the TME. VSV has been shown to infect hepatic stellate cells (HSCs), leading to tumor

fibrosis reduction [126]. OVs affect the tumors vasculature by replicating in the tumor vECs. Vascular endothelial growth factor (VEGF) secreted from tumor vECs suppresses the antiviral response and allows the replication of OVs in endothelial cells through ERK1/2 and STAT3 pathways [127]. Following infection and replication, the OVs reduce VEGF production from the infected cell resulting in angiogenesis prevention in the tumor. OVs' antiangiogenic properties further limit tumor growth by decreasing the oxygen and nutrition supplies [6]. VACV is shown to replicate in the tumor vEC and cause vascular destruction and ischemia [28]. Neutrophil infiltration into the TME seems essential for OVT-mediated ischemia through the induction of thrombosis in small tumor vessels [28]. It has been shown that the administration of JX-594 in hepatocellular carcinoma destroyed tumor vasculature without affecting patients' normal vessels [28]. Thus, targeting of stromal cells by OVs increases the infiltration of immune cells into the TME, and converts immuno-deserted or immune-excluded tumors (with low TILs) into immune-infiltrated tumors [18]. OVT-mediated changes in the TME, including lymphocyte infiltration into the tumor, enhancement of TAAs/TANs presentation, and heating the TME can improve other immunotherapies such as adoptive cell therapy (ACT) and immune checkpoint inhibitors (ICIs) [90].
