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Three major stages of immunoediting: How to completely eliminate cancer cells?
As modern medicine continues to advance, cancer treatments are also evolving. Immunoediting, as an important immune surveillance mechanism, has fundamentally changed our understanding of and response to cancer cells. How to completely eliminate cancer cells depends on understanding the three main stages of immunoediting: elimination, balance, and escape.
Immunoediting is a process that continuously interacts with tumor cells during cancer development.
Phase 1: Elimination
During the first contact between immune and tumor cells, many tumor cells are recognized and eliminated by the host's immune system. This phenomenon is called the elimination phase, which refers to the immune system actively identifying and destroying tumor cells that are considered a threat. During this stage, CD8+ cytotoxic T cells play a key role and can precisely attack tumor-specific antigens.
Phase 2: Balance
However, as they progress through the elimination phase, some tumor cells may develop the ability to evade immune detection. This is the equilibrium stage. The tumor does not completely disappear at this stage, but maintains a dynamic equilibrium with the immune system. During this stage, tumor cells are able to hide from the host's surveillance, and the immune system's scanning capabilities may not be able to cover all tumor cells, resulting in some immune cells being unable to recognize and survive.
This stage is characterized by tumor cells no longer growing rapidly, but still flying below the radar of the immune system.
Stage 3: Escape
Eventually, tumor cells may mutate in this dynamic equilibrium and enter the escape phase. During this stage, tumor cells evade immune surveillance through a series of mechanisms and begin to proliferate, forming more aggressive tumors. Tumor cells can downregulate the expression of antigens from MHC class I or drastically alter the tumor microenvironment by expressing cytokines that promote immunosuppression.
Tumors in the escape stage often show resistance to immunotherapy because some of the cells within them have undergone natural selection, which usually makes them more immune-evasive. This process can be seen as an extension of Darwinian evolution. .
Tumor escape mechanismsTumor cells have a variety of mechanisms to evade immune attack, such as reducing the expression of MHC I to evade detection by CD8+ cytotoxic T cells, or expressing PD-L1 is a key marker for T cell differentiation and remodeling. This allows cancer cells that survive chemotherapy to continue to escape the immune system's surveillance, ultimately forming more deadly tumors.
Current immunotherapies attack these tumor escape mechanisms in an effort to restore normal function of the immune system.
The prospects for immunomodulation and therapy
Scientists are also looking for ways to address this immune escape mechanism. Current progress includes the use of immune checkpoint inhibitors, such as those targeting CTLA-4 and PD-1. code> monoclonal antibodies, these treatments can enhance the immune system's response to tumor cells.
In addition, genetic engineering technologies, such as CAR-T cell therapy, have also shown potential in fighting tumors. These methods are gradually challenging traditional cancer treatments and hope to bring higher efficacy and fewer side effects.
ConclusionThe success of immunotherapy lies in how to promote the full awakening of the immune system to completely eliminate tumors.
By gaining a deeper understanding of the immunoediting process, the scientific community hopes to find the best strategies to fight cancer. But in the face of ever-changing tumor escape strategies, we have to think about how future treatments can continue to evolve to achieve the complete eradication of cancer cells?
