Currently, it is widely acknowledged that a proactive anticancer immunosurveillance mechanism takes part in the rejection of neoplastic lesions before they progress towards a benign or malignant tumour. However in cases of very aggressive neoplastic lesions consisting of cells with high mutational diversity, cancer cell variants might be formed that are capable of evading host defence systems against uncontrolled proliferation and anticancer immunosurveillance. This is mainly accomplished through the exhibition of low immunogenicity, which is a particularly important stumbling block in the revival of long-lasting as well as stable anticancer immunity. Recently, it has emerged emphatically that inciting a cancer cell death routine, associated with the activation of danger signalling pathways evoking emission of damage-associated molecular patterns (DAMPs), markedly increases the immunogenicity of dying cancer cells. This cell death pathway has been termed "immunogenic cell death" (ICD). In the present review we introduce this concept and discuss its characteristics in detail. We also discuss in detail the various molecular, immunological and operational determinants of ICD.
KEY WORDS: immunogenicity, immunogenic cell death, cancer, danger signals, antigen, damage-associated molecular patterns, danger signalling, ER stress, photodynamic therapy (PDT), chemotherapy
Immunogenic cell death: the conceptMost newly formed neoplastic lesions in our body are readily rejected by the host defence system. It is now widely acknowledged that a proactive anticancer immunosurveillance mechanism takes part in rejection of neoplastic lesions before they progress towards a benign or malignant tumour (Dunn et al., 2002, Senovilla et al., 2012. However in cases of very aggressive neoplastic lesions consisting of cells with high mutational diversity; cancer cell variants might be formed that are capable of evading host defence systems against uncontrolled proliferation and anticancer immunosurveillance (Dunn et al., 2002, Zitvogel et al., 2006. In such a scenario, the host immune system might start acting as a "natural selection force" by performing cancer immunoediting, which might lead to the formation of cancer cells that are highly immunoevasive and capable of resisting antitumour immunity (Dunn et al., 2002). Overall resistance against the host anticancer immunosurveillance and antitumour immunity is achieved by various mechanisms including, acquaintance of low immunogenicity, ability to induce immunotolerance or active immunosuppression, and ability to resist immune cell-mediated lysis (Dunn et al., 2002, Garg et al., 2013b, Zitvogel et al., 2006. Here, the exhibition of low immunogenicity is a particularly important stumbling block in the revival Int. J. Dev. Biol. 59: 131-140 (2015) doi: 10.1387/ijdb.150061pa Abbreviations used in this paper: ATP, adenosine triphosphate; CD, cluster of differentiation; CAAs, cancer associated antigens; CRT, calreticulin; DAMP, damageassociated molecular pattern; DC, dendritic cell; ...