慢性炎症诱导免疫抑制的新见解。

New insights into chronic inflammation-induced immunosuppression.

机构信息

The Lautenberg Center for General and Tumor Immunology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.

出版信息

Semin Cancer Biol. 2012 Aug;22(4):307-18. doi: 10.1016/j.semcancer.2012.02.008. Epub 2012 Feb 24.

Abstract

Chronic inflammation is a common factor linking various pathologies that differ in their etiology and physiology such as cancer, autoimmune diseases, and infections. At a certain stage of each of these diseases, while the chronic inflammation proceeds, some key players of the immune system become immunosuppressed as natural killer (NK) cells and T cells. The suppressive environment induced during chronic inflammation is governed by a complex processes characterized by the accumulation and activation of immune suppressor cells, pro-inflammatory cytokines, chemokines, growth and angiogenic factors, and by the activation of several inflammatory signaling pathways mediated predominantly by NFκB and STAT3 transcription factors. A substantial body of evidence supports the notion that the development of a suppressive environment during chronic inflammation limits the success of immune-based and conventional therapies, skewing the balance in favor of a developing pathology. Thus, appropriate, well-designed and fine tuned immune interventions that could resolve inflammatory responses and associated immunosuppression could enhance disease regression and reinforce successful responses to a given therapy. This review describes the interrelationship between chronic inflammation and induced immunosuppression, and explains the current evidence linking inflammation and pathological processes, as found in cancer. We further highlight potential strategies, harnessing the immunosuppressive environment in treating autoimmune diseases and facilitating transplantation. In parallel, we emphasize the use of modalities to combat chronic inflammation-induced immunosuppression in cancer, to enhance the success of immune-based therapies leading to tumor regression. In both cases, the urgent necessity of identifying biomarkers for the evaluation of host immune status is discussed, with the goal of developing optimal personalized treatments.

摘要

慢性炎症是将癌症、自身免疫性疾病和感染等在病因和生理学上不同的多种病理学联系在一起的共同因素。在这些疾病的每个阶段的某个特定阶段,当慢性炎症持续进行时,免疫系统的一些关键参与者会被抑制,如自然杀伤 (NK) 细胞和 T 细胞。慢性炎症过程中诱导的抑制性环境是由复杂的过程所控制的,其特征是免疫抑制细胞、促炎细胞因子、趋化因子、生长和血管生成因子的积累和激活,以及 NFκB 和 STAT3 转录因子介导的几种炎症信号通路的激活。大量证据支持这样一种观点,即在慢性炎症过程中形成抑制性环境会限制免疫和常规治疗的成功,从而使疾病朝着发展的方向倾斜。因此,适当、精心设计和微调的免疫干预措施可以解决炎症反应和相关的免疫抑制,从而增强疾病的消退并加强对特定治疗的成功反应。本综述描述了慢性炎症与诱导性免疫抑制之间的相互关系,并解释了目前将炎症与病理过程联系起来的证据,如在癌症中发现的证据。我们进一步强调了利用免疫抑制环境治疗自身免疫性疾病和促进移植的潜在策略。同时,我们强调了利用方法来对抗癌症中慢性炎症诱导的免疫抑制,以增强基于免疫的治疗导致肿瘤消退的成功。在这两种情况下,都迫切需要确定用于评估宿主免疫状态的生物标志物,以制定最佳的个体化治疗方案。

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