Ilkovitch Dan, Lopez Diana M
Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, FL 33136, USA.
Exp Dermatol. 2008 Dec;17(12):977-85. doi: 10.1111/j.1600-0625.2008.00779.x. Epub 2008 Jul 17.
Melanomas, while the less common of skin cancers, are highly aggressive and once they metastasize usually indicate a poor prognosis. Melanomas are in many cases immunogenic and thus have been a prime target for immunotherapy, which has resulted in objective responses in some patients. To understand why antitumor immunity fails, and for the purpose of discovering new targets to improve therapy, there has been great interest to analyse the antitumor immune responses which exist in these patients, and uncover mechanisms which block tumor-specific immune responses. It is now evident that immunosuppressive cell networks and factors play a major role in the failure of the antitumor immune responses and therapies to eradicate the tumor. In this review, the factors produced by melanomas which can modulate and enhance these suppressive mechanisms are discussed. The roles of immature dendritic cells, neutrophils, T-regulatory cells, myeloid-derived suppressor cells and M2 macrophages or tumor-associated macrophages are described. Furthermore, taking into consideration of the cross-talk which exists among these different cell types and the cycle of immunosuppression which is evident in melanoma cancer patients and animal models, will be important for future therapeutic approaches.
黑色素瘤虽然是较不常见的皮肤癌,但具有高度侵袭性,一旦发生转移,通常预示预后不良。在许多情况下,黑色素瘤具有免疫原性,因此一直是免疫治疗的主要靶点,一些患者已出现客观反应。为了解抗肿瘤免疫为何失败,并为发现改善治疗的新靶点,人们对分析这些患者体内存在的抗肿瘤免疫反应以及揭示阻断肿瘤特异性免疫反应的机制产生了浓厚兴趣。现在很明显,免疫抑制细胞网络和因子在抗肿瘤免疫反应及治疗无法根除肿瘤方面起主要作用。在这篇综述中,将讨论黑色素瘤产生的可调节和增强这些抑制机制的因子。描述了未成熟树突状细胞、中性粒细胞、调节性T细胞、髓源性抑制细胞和M2巨噬细胞或肿瘤相关巨噬细胞的作用。此外,考虑到这些不同细胞类型之间存在的相互作用以及黑色素瘤患者和动物模型中明显的免疫抑制循环,对于未来的治疗方法将很重要。