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Free Content EDITORIAL [Hot Topic: Modulation of the Immune System by Ionizing Irradiation and Chemotherapeutic Agents - Contribution of Immune Activation and Blocking of Immune Suppression to Cancer Therapy Success (Guest Editor: Udo S. Gaipl)]

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Immune suppression induced by chemotherapeutic agents (chemotherapy, CT) and ionizing irradiation (radiotherapy, RT) has often been the cause for a contraindication to combine “classical” tumor therapies with immune therapy (IT). As a single treatment, IT achieved less success as expected. During the last years it has become more and more evident that besides a timely (CT and RT) and locally (RT) restricted immune suppression, a specific activation of the immune system against the therapy-modified tumor is achievable. In addition, IT has been shown to be more beneficial when combined with other therapies, since the immune systems seems not to be capable to deal with big tumor masses, but rather with small tumor burden, recurrent upcoming tumors and metastases.

In this special issue about “Modulation of the immune system by ionizing irradiation and chemotherapeutic agents” attention is given to how CT and RT contribute to activation of innate and adaptive immune responses as well as to blocking of immune suppression. A special focus is set on modulation of the tumor microenvironment, especially on direct and indirect activation of natural killer (NK) and dendritic cells (DCs) against the tumor as well as on general immune modulating properties of RT and/or CT. Based on the array of subsumed preclinical data, concepts are presented how optimized combination schemes of “classical” tumor therapies with immune therapies could appear in the near future.

The immune modulating properties of radiotherapy with ionizing irradiation became evident in the 19th century. Inflammation in joints was temporarily ameliorated after local RT with low doses. Dr. Rodel and colleagues summarise how endothelial cells, mononuclear and polymorphonuclear immune cells are influenced by low dose RT. The current knowledge suggests that most of the radiation-induced immune modulations display discontinuous dose dependencies, shared with “non-targeted“ effects. In many cases, doses in the range of 0.3-0.7 Gy are connected with the strongest anti-inflammatory action of low dose RT. The complexity of the interaction between ionizing radiation and the immune system arises therein, that a higher single dose of RT (2.0 Gy as representative standard single dose in anti-tumor therapy) does not lead to anti-inflammation but rather to specific immune activation under certain microenvironmental conditions....
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Document Type: Research Article

Publication date: 2012-04-01

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