title: Principles of immunology and its nuances in the central nervous system.
abstract: Cancer immunotherapy represents the biggest change in the cancer treatment landscape in the last several years. Indeed, the clinical successes in several cancer types have generated widespread enthusiasm that immune-based treatments may influence the management of patients with malignant brain tumors as well. A number of promising clinical trials in this area are currently ongoing in neuro-oncology, and a wave of additional efforts are sure to follow. However, the basic immunology underlying immunotherapy-and the nuances unique to the immunobiology in the central nervous system-is often not in the daily lexicon of the practicing neuro-oncologist and neurosurgeon. To this end, here we provide a timely and working overview of key principles of fundamental immunology as a pragmatic context for understanding where therapeutic efforts may act in the cellular dynamics of the immune response. Moreover, we review the issues of lymphatic drainage, antigen presentation, and the blood-brain barrier as considerations that are germane to thinking about immunity to tumors arising in the brain. Together, these topics will provide a foundation for the exciting efforts in immune-based treatments that will hopefully provide real benefit to brain tumor patients.
authors.affiliation: Department of Neurological Surgery, Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, Missouri (G.P.D.); Department of Neurological Surgery, Brain Tumor Immunotherapy Center, University of California, San Francisco, Helen Diller Family Cancer Research Building HD 472, San Francisco, California (H.O.).
authors.forename: Gavin P
authors.initials: GP
authors.lastname: Dunn
authors.affiliation: Department of Neurological Surgery, Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, Missouri (G.P.D.); Department of Neurological Surgery, Brain Tumor Immunotherapy Center, University of California, San Francisco, Helen Diller Family Cancer Research Building HD 472, San Francisco, California (H.O.).
authors.forename: Hideho
authors.initials: H
authors.lastname: Okada
mesh_terms: D000818:Animals; D001932:Brain Neoplasms / Q000276:immunology*; D002490:Central Nervous System / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D009369:Neoplasms / Q000276:immunology* / Q000628:therapy*
keywords: adaptive immunity; antigen presentation; blood-brain barrier; immunology; immunotherapy; innate immunity