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CD39, encoded by the gene ectonucleoside triphosphate diphosphohydrolase-1 (ENTPD1), is an integral membrane protein that metabolizes extracellular adenosine triphosphate (ATP) and adenosine diphosphate (ADP) to adenosine monophosphate (AMP). CD39 appears to be the major extracellular enzyme catabolizing ATP in the tumor microenvironment (TME). CD39 is constitutively expressed on immune cell populations, such as B cells, natural killer cells, dendritic cells, Langerhans cells, monocytes, macrophages, mesangial cells, neutrophils, activated T cells, and regulatory T cells (Tregs), as well as endothelial cells. During chronic viral infection in humans and in a mouse model, CD39 is a CD8+ T cell exhaustion marker. In an oncology setting, CD39 is highly expressed by tumor-infiltrating lymphocytes, especially Tregs, exhausted CD8+ T cells, and myeloid-derived cells such as myeloid-derived suppressor cells. In addition, CD39 also is the rate-limiting enzymatic step in the production of immunosuppressive adenosine, and should therefore be viewed as an immunological switch that shifts ATP-driven pro-inflammatory immune cell activity toward an anti-inflammatory, immunosuppressed state mediated by adenosine.