Elkoshi Zeev
Research and Development Department, Taro Pharmaceutical Industries Ltd, Haifa, Israel.
J Inflamm Res. 2022 Dec 15;15:6761-6771. doi: 10.2147/JIR.S392082. eCollection 2022.
A binary classification of the pathogenic immune reactions as anti-inflammatory reactions or pro-inflammatory reactions explains both the relatively low incidence rate of several types of cancer, and the relatively high incidence rate of herpes zoster cases diagnosed in the summer compared to cases diagnosed in the winter (in regions with temperate climate). This binary model also elucidates the longer survival of cancer patients diagnosed during the summer compared to these diagnosed in the winter. The three key elements of this explanation are: (a) the effect of sunlight on Treg production; (b) the evolvement of cancer from a low-Treg condition at early stage, to a high-Treg condition at advanced stage, and (c) the evolvement of herpes zoster from a high-Treg condition at pre-exudative stage to a low-Treg condition at acute exudative stage. A significant proportion of indolent tumors at the time of diagnosis (>20%) is a prerequisite for a beneficial effect of sunlight on cancer incidence rate and prognosis. This prerequisite restricts the beneficial effect of diagnosis during summer to certain types of cancer. Clinical implication: the prognosis of tumors may be improved by a course of corticosteroid (or other immunosuppressant) treatment.
将致病性免疫反应分为抗炎反应或促炎反应，这既解释了几种癌症相对较低的发病率，也解释了在夏季（温带气候地区）诊断出的带状疱疹病例与冬季诊断出的病例相比发病率相对较高的现象。这种二元模型还阐明了夏季诊断出的癌症患者比冬季诊断出的患者生存期更长的原因。这种解释的三个关键要素是：（a）阳光对调节性T细胞产生的影响；（b）癌症从早期低调节性T细胞状态发展到晚期高调节性T细胞状态，以及（c）带状疱疹从渗出前期的高调节性T细胞状态发展到急性渗出期的低调节性T细胞状态。诊断时相当比例（>20%）的惰性肿瘤是阳光对癌症发病率和预后产生有益影响的先决条件。这一先决条件将夏季诊断的有益效果限制在某些类型的癌症上。临床意义：通过一个疗程的皮质类固醇（或其他免疫抑制剂）治疗可能改善肿瘤的预后。
