title: Immune impairment in patients with terminal cancers: influence of cancer treatments and cytomegalovirus infection.
abstract: Although immunodeficiency is usually considered a prerequisite of oncogenesis, a detailed immune pro- file in cancer has not yet been described. Without such profiling, it is not surprising that there is a vast discrepancy in the responses of cancer patients to immunotherapy. Our results show that the integrity of the immune system deteriorates with cancer progression by displaying a trend toward decreasing levels of functional T cells, including CD4, naïve, and central memory T cells, and an expansion of hyporesponsive populations such as CD28⁻ and CMV-specific T cells. One hundred and one patients constitute the study group for the observational study reported in this paper. Forty-eight patients with newly diagnosed stages III and IV and 53 patients with extensively treated stage IV disease. The costimulatory molecules CD27 and CD28 were downregulated in all patients. Among the proinflammatory cytokines (IL-6, TNF-α, IFN-γ), only IL-6 differed significantly among the groups, increasing as the cancer stage progressed. Plasma IL-7 did not diVer among the participants. The relative deficits of naïve T cells in cancer patients may be associated with the downregulation of IL-7Rα expression rather than changes in the circulating levels of IL-7. The downregulation of IL-7Rα expression was shown to be associated with increased levels of intracellular CMV. The present study suggests that the immune impairment in patients with cancer is associated with multiple factors, such as the stage of cancer, consequence of CMV infection and impact of treatment.
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: I-Hsuan
authors.initials: IH
authors.lastname: Chen
authors.forename: Yuen-Liang
authors.initials: YL
authors.lastname: Lai
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Wu
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Chang
authors.forename: Chen-Chung
authors.initials: CC
authors.lastname: Chu
authors.forename: I-Fang
authors.initials: IF
authors.lastname: Tsai
authors.forename: Fang-Ju
authors.initials: FJ
authors.lastname: Sun
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Lu
mesh_terms: D000368:Aged; D018106:CD28 Antigens / Q000276:immunology; D016516:CD4-CD8 Ratio; D017322:Clinical Trials, Phase II as Topic; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000276:immunology*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000276:immunology*; D007156:Immunologic Memory; D007167:Immunotherapy; D053699:Interleukin-7 Receptor alpha Subunit / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology*; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000276:immunology
chemical_list: D018106:CD28 Antigens; D016207:Cytokines; D053699:Interleukin-7 Receptor alpha Subunit; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7
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