Roles of the immune system in skin cancer

Abstract

Over the past several decades, there has been increasing interest in understanding the roles of the immune system in the development and progression of cancer. The importance of the immune system in human skin cancer has been long recognised based primarily upon the increased incidence of skin cancers in organ transplant recipients and mechanisms of ultraviolet light-mediated immunomodulation. In this review, we integrate multiple lines of evidence highlighting the roles of the immune system in skin cancer. First, we discuss the concepts of cancer immunosurveillance and immunoediting as they might relate to human skin cancers. We then describe the clinical and molecular mechanisms of skin cancer development and progression in the contexts of therapeutic immunosuppression in organ transplant recipients, viral oncogenesis, and ultraviolet light-induced immunomodulation with a primary focus on basal cell carcinoma and squamous cell carcinoma. The clinical evidence supporting expanding roles for immunotherapy is also described. Finally, we discuss recent research examining the functions of particular immune cell subsets in skin cancer and how they might contribute to both anti-tumour and pro-tumour effects. A better understanding of the biological mechanisms of cancer immunosurveillance holds the promise of enabling better therapies.

The Distribution of CD8- and Foxp3-positive T Cells in Skin Squamous Cell Tumors and Basal Cell Carcinomas

“…In these studies, the ratio was suggested as a valuable tool for the prediction of development and aggressive growth of transplant associated SCC. Renal transplant recipients showed more increased incidence for SCC than BCC [17]. Previous studies have shown that MHC class I expression and CD8 positive T cell infiltration were significantly decreased in BCC compared to SCC [3,23].…”

“…Ultraviolet radiation is closely implicated in the carcinogenesis of squmaous cell carcinoma (SCC) and basal cell carcinoma (BCC) because it induces DNA mutations and immunosuppression [1,17]. Both tumors frequently occur in organ transplant recipients (OTR), in which their occurrences are also correlated with the level of immunosuppression [8].…”

Advances and Prospects in Cancer Immunotherapy

“…Cancer immunosurveillance refers to the monitoring function of the immune system in cancer development. There are studies that have demonstrated that the immune system can recognize and eliminate aberrant cancer cells arising within the human body [51][52][53][54][55][56]. Thus, the interaction between cancer and the immune system plays a pivotal role in cancer development.…”

HPV vaccination for prevention of skin cancer

“…14,35 Although mortality from NMSC is rare in the immunocompetent population, this malignancy represents a considerable burden on the health-care system, particularly when considering immunosuppressed patients. 7 It is estimated that up to 40% of OTR will develop skin cancers, 90% of which are BCC and SCC, within the first 10 y of transplantation, and up to 80% will do so after 20 y 36 Additionally, skin malignancies are more aggressive in OTRs, with only 56% of 3-year diseasespecific survival. 37 Therefore, a prophylactic strategy that could prevent or reduce the impact of these skin manifestations is much needed.…”