Abstract

The tumour microenvironment is the result of the activity of many types of cells in various metabolic states, whose metabolites are shared between cells. This cellular complexity results in an availability profile of nutrients and reactive metabolites such as advanced glycation end products (AGE). The tumour microenvironment is not favourable to immune cells due to hypoxia and for the existence of significant competition between various types of cells for a limited nutrient pool. However, it is now known that cancer cells can influence the host's immune reaction through the expression and secretion of numerous molecules. The microenvironment can therefore present itself in different patterns that contribute to shaping immune surveillance. Colorectal cancer (CRC) is one of the most important causes of death in cancer patients. Recently, immunotherapy has begun to give encouraging results in some groups of patients suffering from this neoplasm. The analysis of literature data shows that the RAGE (Receptor for advanced glycation end products) and its numerous ligands contribute to connect the energy metabolic pathway, which appears prevalently disconnected by mitochondrial running, with the immune reaction, conditioned by local microbiota and influencing tumour growth. Understanding how metabolism in cancer and immune cells shapes response and resistance to therapy, will provide novel potential strategies to increase both the number of tumour types treated by immunotherapy and the rate of immunotherapy response. The analysis of literature data shows that an immunotherapy approach based on the knowledge of RAGE and its ligands is not only possible, but also desirable in the treatment of CRC.

Highlights

  • In recent years, new mechanisms have been discovered and elucidated that link carcinogenesis with cellular metabolism in colon cancer

  • The interaction of ligands with receptor for advanced glycation end products (RAGE) activates a positive feedback loop by upregulating multiple signalling pathways such as SAPK/c-Jun N-terminal kinase (JNK), Cdc42/Rac, p38 Mitogenactivated protein kinase (MAPK) and ERK1/2 (Ras-extracellular kinase regulated by signal 1/2), which results, once again, in the increase of the transcription factor NF-KB and consequent production of cytokines, adhesive molecules and Matrix metallopeptidases (MMPs) [74]

  • Endogenous ligands as molecules produced and present in the intracellular microenvironment, which, once released in the extracellular space, become signalling molecules aimed at the endogenous activation of the RAGE

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Summary

Introduction

New mechanisms have been discovered and elucidated that link carcinogenesis with cellular metabolism in colon cancer. Binding of RAGE with AGEs activates many signaling pathways active in CRC, such as MAPK, NF-κB, PI3K, Akt, ERK1/2 and JAK-STAT, involved in inflammation, cell survival and cancer progression [30].

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