Prehn Richmond T, Prehn Liisa M
Department of Pathology, University of Washington School of Medicine, Seattle, WA 98118, USA.
Immunol Rev. 2008 Apr;222:341-56. doi: 10.1111/j.1600-065X.2008.00609.x.
The growths of many and perhaps all tumors may be stimulated rather than inhibited by a quantitatively low level of immunity. The reason tumors have antigens may be that tumors do not develop in vivo in the absence of at least a minimal immune reaction; in this sense, cancer may be considered an autoimmune disease. This review, based largely on the work of our own laboratory, outlines the data showing that the titration of anti-tumor immunity exhibits the phenomenon of hormesis, i.e. the dose-response curve is non-linear such that low levels of immunity are generally stimulatory but larger quantities of the same immune reactants may inhibit tumor growth. Evidence is also reviewed that suggests that the immune response may vary qualitatively and quantitatively during progression, such that there seems to be, during oncogenesis, a very low level of immune reaction that aids initial tumor growth, followed by a larger reaction that may cause remission of early neoplasms, followed, if the neoplasm survives, by a relative immunologic tolerance to the tumor that may be dependent, at least in part, on suppressor cells. This knowledge may help to explain some clinical observations concerning the relationships among tumor types and the organ distribution of metastases.
许多肿瘤（或许所有肿瘤）的生长可能会受到低水平免疫力的刺激而非抑制。肿瘤具有抗原的原因可能是，在体内若没有至少最低限度的免疫反应，肿瘤就不会生长；从这个意义上讲，癌症可被视为一种自身免疫性疾病。这篇综述主要基于我们自己实验室的研究工作，概述了相关数据，这些数据表明抗肿瘤免疫力的滴定呈现出兴奋效应现象，即剂量反应曲线是非线性的，以至于低水平的免疫力通常具有刺激作用，但相同免疫反应物的大量存在可能会抑制肿瘤生长。文中还综述了相关证据，这些证据表明在肿瘤进展过程中免疫反应在质量和数量上可能会有所不同，因此在肿瘤发生过程中，似乎存在非常低水平的免疫反应，它有助于肿瘤的初始生长，随后会出现更强的反应，这可能导致早期肿瘤缓解，如果肿瘤存活下来，接着会出现对肿瘤的相对免疫耐受，这至少部分可能依赖于抑制细胞。这一知识可能有助于解释一些关于肿瘤类型与转移灶器官分布之间关系的临床观察结果。
