title: Role of Immunity in Pathogenesis and Treatment of Hepatocellular Carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide with a high mortality. The available treatment options are limited, thus the development of new therapeutic approaches is of a high clinical significance.
  
  
  CONCLUSIONS
  The immune system plays a central role in the pathogenesis of HCC by supporting tumor growth, tumor survival, angiogenesis and the development of vascular infiltration and metastasis. In contrast, the immune system also exhibits a protective role in tumor surveillance, and specific CD8+ T-cells can be detected for various tumor-associated antigens. However, antitumoral potential of the immune system is limited by various inhibitory mechanisms, for example, an impaired priming and activation of CD8+ T-cells, inhibitory cells (e.g., regulatory T-cells) or the expression of inhibitory receptors (e.g., programmed cell death-1 and cytotoxic T-lymphocyte antigen-4). Immunotherapeutic strategies addressing these inhibitory mechanisms, for example, by providing a source of tumor antigens, depleting immunosuppressive cells or blocking inhibitory receptors, aim to induce and boost naturally occurring antitumoral immune responses.
  
  
  CONCLUSIONS
  HCC is a tumor with a high incidence and mortality in developing countries as well as in the Western world. Due to the immune system's central role in the pathogenesis and surveillance of HCC, immunotherapy is a new treatment option that has yielded first promising results.
authors.affiliation: Department of Medicine II, University of Freiburg, Freiburg, Germany.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Schmidt
authors.forename: Robert
authors.initials: R
authors.lastname: Thimme
mesh_terms: D000951:Antigens, Neoplasm / Q000276:immunology; D060908:CTLA-4 Antigen / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008113:Liver Neoplasms / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
chemical_list: D000951:Antigens, Neoplasm; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human