Phases of Immunoediting

The analysis of the relationship and interactions between the immune system and tumors or malignant cells is recognized as cancer immunology.

A malignancy refers to cancerous cells that contain the to invade and eliminate tissue. The progress of malignant cells is often fast and uncontrolled because of the changes in their genetic makeup. [2]

The body displays, detects and destroys malignant skin cells through an activity called immunosurveillance. Immunosurveillance can be used by the disease fighting capability to find any early indicators of possible ruined skin cells such as tumor, before they could develop further. [3] Additionally it is able to inhibit carcinogenesis and help maintain normal cellular homeostasis. Nonetheless it is thought that immunosurveillance is merely a more basic process of cancers immunoediting. [4]

Immunoediting is an activity where the person is protected from cancer tumor cell expansion and the introduction of tumour immunogenicity by the disease fighting capability. It involves three main stages, reduction, equilibrium and escape, also called the three E's. [5]

Elimination stage:

  • Phase 1: Starts out with the initiation of any antitumor immune system response, where the immune system is able to recognise the occurrence of a developing tumor that has undergone stromal remodelling which is creating harm to the tissue. The inflammatory process is triggered leading to the recruitment of natural killer cells, natural killer T cells, macrophages and dendritic skin cells to the site of the tumor. The natural killer skin cells and the natural killer T cells are then stimulated to create IFN-gamma.
  • Phase 2: Recently synthesised IFN-gamma causes incomplete cell lysis of the tumor as well as initiating the production of chemokines. The role of the chemokines is to inhibit the forming of new arteries. The particles from the cell lysis of the tumor is then engulfed by dendritic cells and the dendritic cell migrates to the lymph nodes.
  • Phase 3: Natural killer cells and macrophages transactivate each other due to the existence of IFN-gamma. This then results in apoptosis of the tumor. The dendritic skin cells in the lymph nodes activate the differentiation of Th1 cells which then ends up with the development of Compact disk8 T skin cells.
  • Phase 4: Tumor specific Compact disk4 and Disc8 cells as well as cytolytic T lymphocytes then damage any left over antigen-bearing tumor cells. If a few of the tumor cells stay and haven't been killed off in the reduction phase, then the second phase of immunoediting occurs. [6]

Equilibrium Phase:

Tumor cells which may have survived enter the equilibrium phase. Lymphocytes and IFN-gamma exert a certain amount of pressure on to the tumor cells that are genitically unpredictable and rapidly mutating. [6]

Escape phase:

Tumor cells then enter into the escape stage because of the fact they have built up resistance to elimination. Tumor cells increase and broadened uncontrollably which can cause malignancies. [6] This occurs because of the balance between the disease fighting capability and the tumor to be disturbed resulting in the tumor overtaking. There is rapid tumor growth due to immune system exhaustion or inhibition due to the tumor being repellent to the immune system systems efforts to get rid of it. [7]

A Diagram to illustrate immunoediting:

To conclude, I really do believe that there is a link between the immune system and the development of a malignancy. Tumor infiltration by lymphocytes sometimes appears as a representation of an tumor-related immune response[6].

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