title: Role of toll-like receptors in cervical, endometrial and ovarian cancers: a review.
abstract: OBJECTIVE
  The Toll-like receptors (TLRs) have been implicated in inflammation, innate immunity and cancer. The goal of this paper is to review the available published research about Toll-like receptors and their roles in gynecologic malignancies.
  
  
  METHODS
  A Medline search was conducted and published articles from the late 1990s to the present (2014) were reviewed using search phrases, Toll-like receptors and cervical, endometrial and ovarian cancers.
  
  
  RESULTS
  TLR4 and TLR5 are commonly absent in normal cervix, however TLR5 expression is strong in high grade cervical dysplasia as well as invasive cancer. The expression of TLR3 and TLR4 is low in endometrial cancer. TLR2, TLR3, TLR4 and TLR5 are highly expressed in normal and neoplastic ovarian epithelium. TLR3 has been shown to have a dual function: it can contribute to tumor elimination by upregulation of interferons α and β (INF) and natural killer cell (NK) activation or it can indirectly contribute to tumor progression.
  
  
  CONCLUSIONS
  Inflammation is an essential element in tumorigenesis. Toll-like receptors can trigger an inflammatory response and cell survival in the tumor micro-environment. TLRs are critical immunomodulators that may play an important role in the development of gynecologic cancers. Currently TLR agonists are being investigated for a potential role as an adjuvant in the treatment of gynecologic malignancies.
authors.affiliation: University of Cincinnati College of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 231 Albert Sabin Way, Cincinnati, OH 45267-0526, USA. Electronic address: nader.husseinzadeh@uc.edu.
authors.forename: Nader
authors.initials: N
authors.lastname: Husseinzadeh
authors.affiliation: University of Cincinnati College of Medicine, Department of Obstetrics and Gynecology, 231 Albert Sabin Way, Cincinnati, OH 45267-0526, USA. Electronic address: sara.davenport@uc.edu.
authors.forename: Sara Madison
authors.initials: SM
authors.lastname: Davenport
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000276:immunology*; D002277:Carcinoma / Q000188:drug therapy / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000276:immunology*; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000276:immunology*; D030361:Papillomavirus Infections / Q000276:immunology*; D051193:Toll-Like Receptors / Q000819:agonists / Q000276:immunology*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000276:immunology*
chemical_list: D051193:Toll-Like Receptors
keywords: Cervical, endometrial, ovarian cancers; Gynecologic cancer; Toll-like receptors