Abstract
The development and clinical approval of immunotherapies has revolutionized cancer therapy. Although the role of adaptive immunity in atherogenesis is now well-established and several immunomodulatory strategies have proven beneficial in preclinical studies, anti-atherosclerotic immunotherapies available for clinical application are not available. Considering that adaptive immune responses are critically involved in both carcinogenesis and atherogenesis, immunotherapeutic approaches for the treatment of cancer and atherosclerosis may exert undesirable but also desirable side effects on the other condition, respectively. For example, the high antineoplastic efficacy of immune checkpoint inhibitors, which enhance effector immune responses against tumor cells by blocking co-inhibitory molecules, was recently shown to be constrained by substantial proatherogenic properties. In this review, we outline the specific role of immune responses in the development of cancer and atherosclerosis. Furthermore, we delineate how current cancer immunotherapies affect atherogenesis and discuss whether anti-atherosclerotic immunotherapies may similarly have an impact on carcinogenesis.
Highlights
Prevention strategies and therapeutic opportunities have been significantly improved during the past decades, atherosclerotic cardiovascular diseases (CVD) and cancer still represent the two most common causes of death worldwide [1]
Recent meta-analyses confirmed that low-dose colchicine therapy in patients with coronary artery disease (CAD) was associated with a significantly reduced risk of cardiovascular events (CVE) and a non-significant reduction of cardiovascular deaths, which was counterbalanced by a non-significant increase in noncardiovascular deaths [241, 242]
Considering the robust reduction of CVE observed in these studies as well as the low price and wide availability of the compound, low-dose colchicine might become an option for secondary prevention in high-risk CVD patients, but the increased non-cardiovascular death rates need further investigation
Summary
Prevention strategies and therapeutic opportunities have been significantly improved during the past decades, atherosclerotic cardiovascular diseases (CVD) and cancer still represent the two most common causes of death worldwide [1]. Immunotherapy in Cancer and Atherosclerosis against the pro-inflammatory cytokine interleukin-1β (IL-1β) reduced cardiovascular events in patients with coronary artery disease (CAD), thereby providing first evidence for effectiveness of an immunotherapy in CVD [14] This therapy increased the risk of fatal infections and did not reduce mortality, which prevented its approval for treatment of CVD [14]. Cancer survival has dramatically improved over the past few decades [18], the exposure of cancer survivors to therapy-induced cardiovascular risk represents an emerging problem, which leads to excess cardiovascular mortality and significantly affects long-term prognosis [19,20,21,22] This problem is relevant, as the global cancer burden is expected to increase by ∼47% within the 20 years and to reach more than 28 million cases in 2040 [23]. We will highlight the potential of immunization strategies against cancer and CVD that enable targeted, antigen-specific immunity without affecting the immune system
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