Guglietta Silvia, Rescigno Maria
Department of Experimental Oncology, European Institute of Oncology, I-20139 Milan, Italy.
Department of Experimental Oncology, European Institute of Oncology, I-20139 Milan, Italy; Department of Oncology and Haemato-Oncology, University of Milan, Italy.
Semin Immunol. 2016 Dec;28(6):578-586. doi: 10.1016/j.smim.2016.10.011. Epub 2016 Nov 18.
Hypercoagulation is a common feature of several tumors to the extent that individuals with coagulation defects often present with occult visceral cancers. Recent evidence has shown that hypercoagulation is not just a mere secondary effect due to the presence of the tumor, rather it actively contributes to tumor development and dissemination. Among the numerous mechanisms that can contribute to cancer-associated hypercoagulation, the ones involving immune-mediated processes are gaining increasing attention. In particular, complement cascade and hypercoagulation are one inducing the other in a vicious circle that involves neutrophil extracellular traps (NETs) formation. Together, in this feedback loop, they can promote the protumorigenic phenotype of immune cells and the protection of tumor cells from immune attack, ultimately favouring tumor development, progression and metastases formation. In this review, we summarize the role of these processes in cancer development and highlight new possible intervention strategies based on anticoagulants that can arrest this vicious circle.
高凝状态是几种肿瘤的常见特征，以至于有凝血缺陷的个体常伴有隐匿性内脏癌。最近的证据表明，高凝状态不仅仅是肿瘤存在导致的单纯继发效应，而是积极地促进肿瘤的发展和扩散。在众多可导致癌症相关高凝状态的机制中，涉及免疫介导过程的机制正受到越来越多的关注。特别是，补体级联反应和高凝状态在一个涉及中性粒细胞胞外诱捕网（NETs）形成的恶性循环中相互诱导。在这个反馈回路中，它们共同促进免疫细胞的促肿瘤表型以及保护肿瘤细胞免受免疫攻击，最终有利于肿瘤的发展、进展和转移形成。在本综述中，我们总结了这些过程在癌症发展中的作用，并强调基于抗凝剂的新的可能干预策略，这些策略可以阻止这个恶性循环。
