İmmün sistem hücreleri, bir yandan kanser hücrelerine karşı antitümöral etkinlik gösterirken diğer yandan kronik inflamasyon zemininde tümör gelişimi ve progresyonunda rol alırlar. Yani inflamasyon, tümör hücrelerini ortadan kaldırabildiği gibi karsinogeneze katkı da sağlayabilir. İnflamasyonun bu ikili rolü, immün yetmezliği olan hastalarda daha çok kanser gelişimi yönünde kendini gösterir. Kronik inflamasyon kanserde önemli bir role sahipken, akut inflamasyonun tümör ilerlemesi üzerindeki etkisi hakkında daha az şey bilinmektedir. İlginç bir şekilde, uzun süreli nonsteroid antiinflamatuar ilaçların kullanımı sonucu kronik inflamasyonun baskılanması, özellikle kolorektal kanserler için risk azalımı sağlamaktadır. Dolayısıyla inflamatuar yanıtı terapötik olarak ayarlayabilmek, kansere karşı mücadelede çok önemli olacaktır. Adaptif T hücrelerini ve antikorları içeren pasif immünoterapilerle son zamanlarda yüz güldürücü sonuçlar elde edilmiştir. Ancak doğuştan gelen (innate) immün sistemin, endojen olarak ortaya çıkan kanseri nasıl tanıdığı, moleküler düzeyde yeterince anlaşılmamıştır ve bu, aktif kanser immünoterapisinin geliştirilmesinde önemli bir engel teşkil etmektedir. Kanser hücreleri ve doğuştan gelen (innate) immün sistem hücrelerinin doğrudan veya dolaylı yollarla etkileşim mekanizmalarını aydınlatmak, mevcut immünoterapilerin de etkisini potansiyelize edecektir. Güncel literatür daha çok immün hücrelerin aktivasyonunun kanser hücreleri ile savaşta önemli role sahip olduklarından bahsetmektedir. Bu derlemede, kanserin gelişiminden son evresine dek olan süreçte, özellikle doğal (innate) immün sistem elemanlarının kronik inflamasyon zemininde kanser oluşumu ve progresyonundaki rollerini değerlendirmeye çalıştık.
Anahtar Kelimeler: Karsinogenez; bağışıklık sistemi; doğal bağışıklık; kazanılmış bağışıklık
Immune system cells show antitumoral activity against cancer cells but they also play a role in tumor development and progression on the basis of chronic inflammation. In other words, inflammation can both eliminate tumor cells and contribute to carcinogenesis. This dual role of inflammation is more evident in the development of cancer in immunocompromised patients. Although chronic inflammation has an important role in cancer, the effect of acute inflammation on tumor progression is less known. Suppression of chronic inflammation as a result of long-term use of nonsteroidal anti-inflammatory drugs interestingly provides a reduced risk, especially for colorectal cancers. Therefore therapeutically adjusting the inflammatory response will be crucial in the fight against cancer. Promising results have been obtained with passive immunotherapy including adaptive T cells and antibodies, recently. However, how the innate immune system recognizes endogenous cancer is poorly understood at the molecular level, and this still represents a major obstacle to the development of active cancer immunotherapy. Illüminating the interaction mechanisms of cancer cells and innate immune system cells directly or indirectly will potentiate the effect of exist immunotherapies. Current literature generally mentions that the activation of immune cells has an important role in the fight against cancer cells. In this review, we tried to evaluate the role of innate immune system elements in the formation and progression of cancer in the context of chronic inflammation, from the development of cancer to its final stage.
Keywords: Carcinogenesis; immune system; innate immunity; adaptive immunitiy
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