Surgical trauma‐induced immunosuppression in cancer: Recent advances and the potential therapies

Fan Tang; Yan Tie; Chongqi Tu; Xiawei Wei

doi:10.1002/ctm2.24

journal article Open Access Mar 01, 2020

Surgical trauma‐induced immunosuppression in cancer: Recent advances and the potential therapies

Fan Tang Yan Tie Chongqi Tu

Xiawei Wei

Clinical and Translational Medicine Vol. 10 No. 1 pp. 199-223 · Wiley

View at Publisher Save 10.1002/ctm2.24

Abstract

AbstractSurgical resection remains the mainstay treatment for solid cancers, especially for localized disease. However, the postoperative immunosuppression provides a window for cancer cell proliferation and awakening dormant cancer cells, leading to rapid recurrences or metastases. This immunosuppressive status after surgery is associated with the severity of surgical trauma since immunosuppression induced by minimally invasive surgery is less than that of an extensive open surgery. The systemic response to tissue damages caused by surgical operations and the subsequent wound healing induced a cascade alteration in cellular immunity. After surgery, patients have a high level of circulating damage‐associated molecular patterns (DAMPs), triggering a local and systemic inflammation. The inflammatory metrics in the immediate postoperative period was associated with the prognosis of cancer patients. Neutrophils provide the first response to surgical trauma, and the production of neutrophil extracellular traps (NETs) promotes cancer progression. Activated macrophage during wound healing presents a tumor‐associated phenotype that cancers can exploit for their survival advantage. In addition, the amplification and activation of myeloid‐derived suppressor cells (MDSCs), regulatory T cells (Tregs) or the elevated programmed death ligand‐1 and vascular endothelial growth factor expression under surgical trauma, exacerbate the immunosuppression and favor of the formation of the premetastatic niche. Therapeutic strategies to reduce the cellular immunity impairment after surgery include anti‐DAMPs, anti‐postoperative inflammation or inflammatory/pyroptosis signal, combined immunotherapy with surgery, antiangiogenesis and targeted therapies for neutrophils, macrophages, MDSCs, and Tregs. Further, the application of enhanced recovery after surgery also has a feasible outcome for postoperative immunity restoration. Overall, current therapies to improve the cellular immunity under the special condition after surgery are relatively lacking. Further understanding the underlying mechanisms of surgical trauma‐related immunity dysfunction, phenotyping the immunosuppressive cells, and developing the related therapeutic intervention should be explored.

Topics

No keywords indexed for this article. Browse by subject →

References

216

[1]

10.1056/nejmoa1701830

[2]

Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial

Joel Shapiro, J Jan B van Lanschot, Maarten C C M Hulshof et al.

The Lancet Oncology 10.1016/s1470-2045(15)00040-6

[3]

10.3322/caac.21498

[4]

10.1007/s10585-018-9896-8

[5]

Surgery for Cancer: A Trigger for Metastases

Samer Tohme, Richard L Simmons, Allan Tsung

Cancer Research 10.1158/0008-5472.can-16-1536

[6]

10.1245/s10434-018-6691-3

[7]

Krall JA "The systemic response to surgery triggers the outgrowth of distant immune‐controlled tumors in mouse models of dormancy" Sci Transl Med (2018) 10.1126/scitranslmed.aan3464

[8]

10.1046/j.1365-2362.2000.00622.x

[9]

10.1245/s10434-014-4348-4

[10]

Porta C "Immunological stress in kidney cancer patients undergoing either open nephrectomy or nephron‐sparing surgery: an immunophenotypic study of lymphocyte subpopulations and circulating dendritic cells" Oncol Rep (2008)

[11]

10.1016/j.soard.2008.08.019

[12]

10.1002/jso.25725

[13]

10.4049/jimmunol.1501677

[14]

Coosemans A "Immunosuppressive parameters in serum of ovarian cancer patients change during the disease course" Oncoimmunology (2015) 10.1080/2162402x.2015.1111505

[15]

10.1111/iju.12086

[16]

Kaya M "Concomitant tumour resistance in patients with osteosarcoma. A clue to a new therapeutic strategy" J Bone Joint Surg Br (2004) 10.1302/0301-620x.86b1.14069

[17]

Zheng C "Minimally invasive video‐assisted versus conventional open thyroidectomy on immune response: a meta analysis" Int J Clin Exp Med (2015)

[18]

10.1080/08820139.2017.1296859

[19]

10.1002/ijc.29998

[20]

10.1093/icvts/ivy231

[21]

10.1067/msy.2000.101152

[22]

10.1016/s0140-6736(02)09290-5

[23]

Dedej T "Alterations in homeostasis after open surgery. A prospective randomized study" G Chir (2013)

[24]

10.1007/bf02725341

[25]

10.1002/jso.25725

[26]

10.1038/sj.embor.7400759

[27]

10.1007/s00134-015-4205-3

[28]

Lefrançais E "Mechanisms of IL‐33 processing and secretion: differences and similarities between IL‐1 family members" Eur Cytokine Netw (2012) 10.1684/ecn.2012.0320

[29]

10.1073/pnas.1115884109

[30]

10.1172/jci89867

[31]

10.1016/j.ajpath.2015.11.025

[32]

10.1164/rccm.201206-1037oc

[33]

10.1097/shk.0b013e3182471795

[34]

10.1016/j.intimp.2017.10.033

[35]

10.1371/journal.pone.0202594

[36]

10.1158/0008-5472.can-15-3051

[37]

10.1016/j.hlc.2017.02.014

[38]

10.1002/iid3.236

[39]

10.1371/journal.pone.0183640

[40]

Gout-associated uric acid crystals activate the NALP3 inflammasome

Fabio Martinon, Virginie Pétrilli, Annick Mayor et al.

Nature 10.1038/nature04516

[41]

Damage-associated molecular patterns and their role as initiators of inflammatory and auto-immune signals in systemic lupus erythematosus

Karen Álvarez, Gloria Vasquez

International Reviews of Immunology 10.1080/08830185.2017.1365146

[42]

10.15698/cst2019.06.190

[43]

Circulating mitochondrial DAMPs cause inflammatory responses to injury

Qin Zhang, Mustafa Raoof, Yu Chen et al.

Nature 10.1038/nature08780

[44]

10.21037/jtd.2019.10.26

[45]

10.1007/s00134-015-4205-3

[46]

10.1016/j.mcn.2018.04.005

[47]

10.1042/bsr20181709

[48]

10.1016/j.jss.2018.05.059

[49]

10.1093/intimm/dxy016

[50]

10.1016/j.clinthera.2016.02.028

Showing 50 of 216 references

Cited By

162

Current Status and Prospects of Anesthesia and Breast Cancer: Does Anesthetic Technique Affect Recurrence and Survival Rates in Breast Cancer Surgery?

Ryungsa Kim, Ami Kawai · 2022

Frontiers in Oncology

The role of neutrophil extracellular traps in cancer progression and metastasis

Meghan L. De Meo, Jonathan D. Spicer · 2021

Seminars in Immunology

Metrics

162

Citations

216

References

Details

Published: Mar 01, 2020
Vol/Issue: 10(1)
Pages: 199-223
License: View

Authors

F

Fan Tang

State Key Laboratory of Biotherapy and Cancer Center West China Hospital Sichuan University Chengdu Sichuan People's Republic of China; Department of Orthopeadics West China Hospital Sichuan University Chengdu Sichuan People's Republic of China

Y

Yan Tie

Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China Chengdu Sichuan People's Republic of China

C

Chongqi Tu

Department of Orthopeadics West China Hospital Sichuan University Chengdu Sichuan People's Republic of China

X

Xiawei Wei

State Key Laboratory of Biotherapy and Cancer Center West China Hospital Sichuan University Chengdu Sichuan People's Republic of China

Funding

China Postdoctoral Science Foundation Award: 2019M663509

Cite This Article

Fan Tang, Yan Tie, Chongqi Tu, et al. (2020). Surgical trauma‐induced immunosuppression in cancer: Recent advances and the potential therapies. Clinical and Translational Medicine, 10(1), 199-223. https://doi.org/10.1002/ctm2.24

Surgical trauma‐induced immunosuppression in cancer: Recent advances and the potential therapies

You May Also Like