Review article: immune suppression and colorectal cancer

Summary Background Advances in immunology and molecular biology have shown that colorectal cancer is potentially immunogenic and that host immune responses influence survival. However, immune surveillance and activation is frequently ineffective in preventing and/or controlling tumour growth. Aim To...

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Published in:Alimentary pharmacology & therapeutics 2006-10, Vol.24 (8), p.1163-1177
Main Authors: EVANS, C., DALGLEISH, A. G., KUMAR, D.
Format: Article
Language:English
Subjects:
Apoptosis - immunology
CD4-Positive T-Lymphocytes - immunology
Colorectal Neoplasms - immunology
Cyclooxygenase 2 - metabolism
Down-Regulation - immunology
Histamine - immunology
Histocompatibility Antigens Class I - analysis
Histocompatibility Antigens Class I - immunology
HLA Antigens - analysis
HLA-G Antigens
Humans
Immune Tolerance - immunology
Interleukin-10 - immunology
Signal Transduction - immunology
T-Lymphocytes - immunology
Transforming Growth Factor beta - immunology
Vascular Endothelial Growth Factor A - immunology
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Summary:Summary Background Advances in immunology and molecular biology have shown that colorectal cancer is potentially immunogenic and that host immune responses influence survival. However, immune surveillance and activation is frequently ineffective in preventing and/or controlling tumour growth. Aim To discuss potential ways in which colorectal cancer induces immune suppression, its effect upon prognosis and avenues for therapeutic development. Method A literature review was undertaken for evidence of colorectal cancer‐induced immune suppression using PubMed and Medline searches. Further studies were identified from the reference lists of identified papers. Results Immune suppression occurs at a molecular and cellular level and can result in a shift from cellular to humoral immunity. Several mechanisms for immune suppression have been described affecting innate and adaptive immunity with suppression linked to poorer clinical outcome. Conclusions Colorectal cancer causes direct inhibition of the host's immune response with a detrimental effect upon prognosis. Immunotherapy offers a therapeutic strategy to counteract these effects with promising results seen particularly in precancerous conditions and early tumours. This review strongly suggests that immunotherapy should be incorporated into adjuvant therapeutic trials for stage 2 tumours and be considered as adjuvant treatment in conjunction with standard chemotherapy regimes for advanced disease.
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2006.03075.x