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How did the medical community uncover the mysterious connection between tumors and inflammation in 1863?
At an important moment in 1863, the famous German pathologist Rudolf Virchow first made the subtle relationship between tumors and inflammation public. In the past, the origin of tumors was often seen as related to certain cell mutations in the body, but Virchow's discovery revealed the important role of inflammation in tumor development and opened a new door to understanding.
Tumors do not exist in isolation. Their formation and development are heavily dependent on changes in the surrounding environment, especially the impact of inflammatory responses.
Virchow's insights underscore the importance of the tumor microenvironment, which is composed not only of tumor cells but also blood vessels, immune cells, fibroblasts, and a variety of signaling molecules. The interactions between these components are complex and subtle, supporting tumor growth, invasion, and resistance to treatment.
Since Virggio, the medical community has continued to deepen its research on the tumor microenvironment. In 1889, Stephen Paget proposed the famous "seed and soil" theory. He pointed out that tumor cells will prefer certain specific sites during the metastasis process, just as seeds need suitable soil to grow. This theory uses vivid metaphors to emphasize the importance of the microenvironment for tumor spread.
Just like the air we breathe, the microenvironment of tumors is key to their survival and reproduction.
Further research found that the tumor microenvironment also changes continuously with tumor development. Tumor cells can affect the surrounding environment by releasing extracellular signals. These changes can promote tumor angiogenesis and induce peripheral immune tolerance. Changes in this microenvironment are closely related to tumor growth and evolution.
Today, scientists have recognized that the vasculature in the tumor microenvironment is critical for tumor growth. In tumors smaller than 1-2 mm in diameter, oxygen and nutrients are supplied mainly by passive diffusion. However, as the tumor grows, the cells in the central part cannot receive sufficient blood supply, resulting in a hypoxic and acidic microenvironment. Tumors accordingly regulate their angiogenic capabilities to supply the resources needed for growth.
During angiogenesis, tissues under hypoxic conditions release signals called hypoxia-inducible factors (HIFs), which stimulate nearby endothelial cells to secrete vascular endothelial growth factor (VEGF) and guide the formation of new blood vessels. However, the blood vessels formed in the tumor environment are often under-mature. Therefore, the vascular structure of the tumor microenvironment is very different from that of normal tissue, often showing "funnel-like" and twisted characteristics.
As our understanding of the tumor microenvironment deepens, the role of tumor immune cells has also attracted widespread attention. These cells may play dual roles in suppressing tumors or promoting tumor growth. Tumor-associated immune cells, such as regulatory T cells and myeloid-derived suppressor cells, are often upregulated in the tumor microenvironment, thereby inhibiting the occurrence of anti-tumor immune responses.
Myeloid-derived suppressor cells are thought to be a heterogeneous population of tumor-promoting cells. These cells may inhibit T cell activity while supporting angiogenesis, further promoting tumor spread. Tumor-associated macrophages are central elements in the strong link between inflammation and tumors.
Inflammation may play a double-edged sword role in tumor growth, either inhibiting tumor expansion or promoting its growth.
Whether it is the blood vessels of the tumor microenvironment, emerging immune cells, or various biochemical signals related to tumor growth, these factors together form a complex ecosystem. How to use this knowledge to promote the treatment and prevention of cancer will be an important issue that the medical community needs to face in the future.
A study in London points out that effective anti-tumor therapy requires a comprehensive consideration of various factors in the tumor microenvironment in order to propose more targeted treatment options for the tumor's response. In this rapidly changing medical field, will the way tumors respond fundamentally change with the understanding of the microenvironment?
