title: Mechanisms underlying the association between obesity and Hodgkin lymphoma.
abstract: A solid body of knowledge indicates that overweight and obese subjects are prone to develop cancer, aggressive disease, and death more than their lean counterparts. While obesity has been causally associated with various cancers, only a limited number of studies beheld the link with classical Hodgkin lymphoma (HL). Contemporary meta-analysis and prospective studies confirmed the association of body mass index with HL. Besides epidemiological evidence, excess adiposity is known to influence tumor behavior through adipokines, adipose-derived stem cell migration, and metabolism regulation, and by modulating immunoinflammatory response. Nevertheless, the obesity paradox has been described in few cancers. Considering that adipose tissue is an immunomodulatory organ, and that inflammation is the cornerstone of HL pathophysiology, the rationale for being causally related due to endocrine/paracrine interactions cannot be negligible. In this hypothesis-generating review, we explore the biologically plausible links between excess adiposity and HL in light of recent basic and clinical data, in order to create a basis for understanding the underlying mechanisms and foster applied research. The establishment of an association of excess adiposity with HL will determine public health preventive measures to fight obesity and eventually novel therapeutic approaches in HL patients.
authors.affiliation: Genetics Laboratory and Environmental Health Institute, Faculdade de Medicina, Universidade de Lisboa, Lisbon, 1649-028, Portugal. andreiamatos@medicina.ulisboa.pt.|Instituto de Investigação Científica Bento da Rocha Cabral, Lisbon, 1250-047, Portugal. andreiamatos@medicina.ulisboa.pt.
authors.forename: Andreia
authors.initials: A
authors.lastname: Matos
authors.affiliation: Molecular Oncology Group, Portuguese Institute of Oncology Porto Centre, Porto, 4200-072, Portugal.|Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, 4050-313, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Marinho-Dias
authors.affiliation: Oncohematology Department, Portuguese Institute of Oncology Porto Centre, Porto, 4200-072, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ramalheira
authors.affiliation: i3S-Instituto de Investigação e Inovação em Saúde/INEB-Institute of Biomedical Engineering, University of Porto, Porto, 4200-135, Portugal.|Department of Pathology and Oncology, Faculty of Medicine, University of Porto, Porto, 4200-319, Portugal.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Oliveira
authors.affiliation: Genetics Laboratory and Environmental Health Institute, Faculdade de Medicina, Universidade de Lisboa, Lisbon, 1649-028, Portugal.|Instituto de Investigação Científica Bento da Rocha Cabral, Lisbon, 1250-047, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Bicho
authors.affiliation: Genetics Laboratory and Environmental Health Institute, Faculdade de Medicina, Universidade de Lisboa, Lisbon, 1649-028, Portugal. oriebir.r@gmail.com.|Instituto de Investigação Científica Bento da Rocha Cabral, Lisbon, 1250-047, Portugal. oriebir.r@gmail.com.|Molecular Oncology Group, Portuguese Institute of Oncology Porto Centre, Porto, 4200-072, Portugal. oriebir.r@gmail.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ribeiro
mesh_terms: D006689:Hodgkin Disease / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D009765:Obesity / Q000150:complications*
keywords: Bone marrow adipocytes; Hodgkin lymphoma; Obesity; Tumor microenvironment