2. INTRODUCTION
• Increased incidence of cancer due to inefficiency
of immunosurveillance that result due to
Ageing
Congenital immunodeficiency
Acquired immunodeficiency
• The immune response to cancer can be broadly divided into innate and
acquired components
• Innate immunity serves as a first line defense against cancer, as germ line
encoded pattern recognition receptors rapidly detect infected or stressed
cells, there by triggering potent effector mechanism aimed at tumor
containment.
3. Cont…
• In contrast, adaptive immunity reflecting the requirement for
activation and expansion of rare tumor-associated antigen-specific
lymphocytes harboring somatically rearranged immunoglobulin or T-
cell receptors.
• NKT cells and γδT cells function at the interface of innate and
adaptive immunity.
• The interplay of tumor cells and endogenous immunity is increasingly
recognized to play a decisive role throughout the multiple stages of
carcinogensis.
4. INNATE ANTI-TUMOR RESPONSES
• The innate immune system functions as an extrinsic surveillance
mechanism for genotoxic injury.
• These innate immunity responses may contribute to tumor suppression,
their aberrant activation may also prove deleterious when normal tissues
are perturbed as during auto-immunity or chronic inflammation.
• When NKG2D ligands are expressed on the surface of stressed cells
triggers NKG2D dependent activation of NK, NKT, and γδ T-cells which
inhibit tumor growth through cytotoxicity and IFN-γ production.
5. Cont….
• Additionally, some heat shock proteins-70, uric acid, HMGB1 are
produced which activates macrophages and dentritic cells.
• In microenvironment of tumor cells have been demonstrated to cleave
NKG2D ligands from their surface via the isomerase ERp5 ADAM
metalloprotienases, which further fuel the immune suppression.
8. ADAPTIVE ANTI-TUMOR RESPONSES
• Adaptive antitumor responses is typically by dendritic cells which capture dying tumor cells,
process the antigenic cargo for MHC class I and II presentation, migrate draining lymph nodes
and stimulate antigenic- specific T and B lymphocytes .
• In tumor microenvironment the dentritic cell may activated by danger signals released from
stressed or necrotic tumor cells, there by triggering a maturation program that includes
expansion of multiple co-stimulatory molecules and cytokines that result in effector T-cell
responses.
• CD4+ T cell CD40 ligand expression may trigger CD40 signaling on dentritic cell resulting in
enhanced IL-12 productions and the differentiation of IFN-γ and cytotoxic T lymphocytes.
9. MECHANISM OF ESCAPE
• Elimination—Immune
cells mount the initial
antitumor response.
• Equilibrium—Insufficient
elimination enables
developing tumor to acquire
tumor evasive mechanisms
• Escape—Tumor cell
evasion results in cancer
progression.
10. • Certain tumor cells may shed or stop expressing the
surface antigen thus making the tumour cell
immunologically invisible
Modulation Of
Surface Antigen
• Some cancer produce a mucoprotein called
sialomucin. It bind to the surface of the tumour cell.
Since sialomucin is a normal component, the tumour
cell are not recognised by immune system
Masking Tumour
Antigens
• Certain tumour cell evokes immune system to
produce blocking antibodies, which can not fix and
activate complement, resulting in prevention of
tumor cell lysis.
Production Of
Blocking
Antibody
11.
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13.
14. • Due to the fast rate of proliferation of malignant cells
tumor may be able to sneak through before the
development of an effective immune response and
once they reach a certain mass, the tumour may be too
great for the host immune system to control
Fast Rate Of
Proliferate Of
Malignant Cell
• Some tumour may form cytokine like Tranforming
Growth Factor β (TGF-β) which suppressed CMI
Suppression Of
Cell Mediated
Immunity (CMI)