• ICV 2015:77.31
  • ICV 2016:92.32
  • ICV 2017:100.00

From the Editor’s Desk

INFLAMMATION AND ANGIOGENESIS IN CANCER

The idea that cancer is related to inflammation, was proposed about 150 years ago by the founding father of cellular pathology- Virchow; and has now been accepted. Now we know for sure that cancer is closely related to inflammation.
There are many similarities in the above processes which are much intertwined with each other for tumor formation.
Moreover, now, neo angiogenesis has also been accepted as a basic necessity of both the inflammation and cancer to fully develop them.
The research is still continued to timely investigate basic chemical and molecular functions, pathway and their role / target for developing interventional points.
With the passage of time and the accumulating knowledge, scientists slightly modified the multi step theory of neoplasm development by adding one more step to the already defined the six one
Viz- 1. Continuing signaling for proliferative growth,
2. Evading growth suppressor
3. Resisting cell death
4. Allowing for replicative immortality by persistent cell division.
5. Neoangiogenesis.
6. Activating invasion and metastasis
Now 7th step that is cancer related inflammation has been added to this list.
The evidences have been many for supporting this fact. Many times doctors and scientist have observed cancer developing near the site of chronic inflammation. Now the discovery about factors secreted by these inflammatory cells have also been characterized in groups of chemokines, cytokines, growth factors etc. Practically all types of inflammatory cells have been involved in this process of inflammation and cancer and few to large number of cells were also seen in the biopsy tissue of tumors. Histopathologically, groups of tumor cells were surrounded by these inflammatory cells. This supported the imagination of scientists that the inflammatory cells and off-course many immune cells amongst these were fighting the tumor cells by physically surrounding them, trying to finish in a war like situation. The tumor overtook and grew, is evident by tumor remaining present and inflammatory and immune cells still persisting in the effort. Never-the-less, the inflammatory cells transformed into immune cells were found to have opposite roles as well.
Many cancers seen by the pathologists show large number of inflammatory cells like prostate cancer, breast cancer, cervical cancer, oral cancer, bladder cancer etc. These testify inflammation being present and associated in these cases.
These inflammations could have been caused by associated infection like helicobacter pylori in stomach and gall bladder, worms (helminthes) in urinary bladder, hepatitis virus in liver cancer and auto-immune process in Gastrointestinal cancer.
Gradually, where various chemical steps of inflammations, along with different cells were identified from the site of inflammation and later when advanced analytical techniques came up, several markers viz cytokines, chemokines and other sections of cells were identified.
How these cells and their secretions transmit the signals for either exciting or silencing other site/ cell or pathways was gradually understood. Numerous metabolic pathways were appreciated as at that time all efforts focused to discover the cause / factor which led to cell growth. The focus was mostly on tumor cells. Animal models were developed to produce tumors in mice, nude mice, genetically altered mice and mice with either activated oncogene or silenced gene.
Nearly 50 - 60 years ago, workers observed and concluded that neo-vascularization for developing tumor was very essential. This was reflected in presence and increased formation of newer blood vessels at different stage of maturity and vascular growth factor, on the site near developing tumor in man. Although previously, this was many times visibly observed at the site of inflammation but it was never catches by workers till the insight came, at inflammatory loci, swellings etc, that it could be same in tumor. Several factors were responsible for this increased vascularization of the growing tumor mass like hypoxia and hypoxia induced factors alpha (HIFα) factor VIII, VEGF C, EGF and IL-8 and tumor associated macrophages (TAM) etc.
The most important vascular growth factor ie VEGF, VEGF-1 and other foremost were recognized and differently named.
Since, this was not a cell-surfaced appearing phenomenon; it had not stricken the thinking of the researcher.
Lots of experiment and associated clinical trials have shown that the VEGF is the main factor responsible for angiogenesis, and helps in metastasis by increasing vascular permeability. This is also associated with metastasis due to associated hyper permeability.
Chemokines family of ligands and receptors are another important group which is responsible for angiogenic processes like CXC-8. This is up-regulated in some cancers and causes Microvascular ligation and when inhibited, causes vascular necrosis.
Recently some micro RNAs have come in-to picture for promoting both inflammation and cancer like miR -26. However, the response of miR-126 in different circumstances of expression have opposite effect on angiogenesis.
Although, we have seen that all types of inflammatory cells and immune cells comprise micro-environmental milieu, the most important cells are tumor associated macrophage (TAM). They promote angiogenesis and lymphangiogenesis by releasing different type of interleukins.
Last but not the least, while during inflammation, reactive oxygen species and RNA molecule are produced, and so they are produced in cancer.
Many of these function as regulators of signaling pathways. The ROS are also responsible for secretion of VEGF-A; involved in neo- angiogenesis.
Many of the above facts have been used to make anti – angio-genic molecule to be used as drug. Since antiangiogenic drug have been tried and tested well in the last three-decades of clinical trials, scientists are enthusiastic for intervening at more and more metabolic points in pathways. It is therefore why much needed understanding of deeper molecular functioning is required.
What could be more better than targeting either inflammation or angiogenesis to prevent and treat cancer.

For Direct manuscript Submission to Editorial office mail to ejmreditor1@gmail.com

Table of Content

Era's Journal of Medical Research: Volume-5 Number-2

PICTURE GALLERY

News
  • SJIF 2018 = 5.07
  • Due to some unavoidable circumstances the PhD. entrance examination has been postponed from 29.07.2017 to 05.08.2017.... Read more...
  • M.B.B.S student Mr. Paarth Garg awarded Cancer Research Training Exchange Fellowship for Italy." Read more...
  • Admission Notice on Vacant Seats 2017... Read more...
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  • International Institute of organized Research I2OR Awards 2017.... Read more...
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  • Best Poster Award Phoenix 2017, International Medical Student Conference Mangalore.... Read more...
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  • 2nd Revised Basic Course Workshop in Medical Education & Technology.... Read more...
  • MoU signed between Era’s Lucknow Medical College & Hospital and Institute of Nano Science and Technology, Mohali.... Read more...
  • ELMC&H student Mr. Parth Garg reaching International Boundaries.... Read more...
  • Foundation program for MBBS students batch-2016 was organised on 15&17 October 2016.... Read more...
  • Dr. Ritika Srivastava got 2nd prize at COSDERMINDIA - 2016 at Mumbai.... Read more...
  • Mr. Parth Garg got first prize at BIMSSCON 2016 at Dhaka, Bangladesh for his work on "Fate of MSCs in OGD induced hypoxia.... Read more...
  • Revised Basic Course Workshop for faculty development was organised during 28-30 September 2016.... Read more...