Chemotherapy and the Immune Response
It is known that chemotherapy is the treatment against cancer that better debilitate the immune system since the drugs used during chemotherapy affect divided cells rapidly. Likewise, this process is carried out by many of the body’s cells that can be found in the blood, the mouth, the digestive tract, the nose, the nails, the vagina, and the hair.
Cancer cells are damaged by chemotherapy because they cannot be repaired alone. Healthy cells can usually repair damage from chemotherapy after treatment is finished. One exception is nerve cells in the hands and feet, which some chemotherapy drugs can permanently damage. As chemotherapy drugs damage the bone marrow, the marrow is less able to make red blood cells, white blood cells, and platelets. The most significant impact typically falls on the white blood cells. If the body does not have enough white blood cells, the body is more vulnerable to infection.
In general, chemotherapy has been recognized to depress the immune system. It is common to see a decrease in white blood cells with chemotherapy. However, even in this reduction in white blood cell count, chemotherapy can stimulate the immune system.
This situation could be contradictory; however, it is known that the immune system can attack tumors and protect them. So, if you can debilitate protective cells, in other words, regulatory cells that include Tregs and CSDMs, you can achieve a positive balance in the immune response against cancer.
What are some of the beneficial effects that chemotherapy can have? One of these effects is the death of immunogenic tumor cells through mechanisms that cause tumor antigens to be released and danger signals to be stimulated. Tumors killed by these methods can help enhance an immune response.
Furthermore, increasingly cancer produces many immuno-inhibitory substances, both by direct protein production and by-products of its metabolism. If cancer growth is directly suppressed by chemotherapy, it can be reduced, facilitating the work of the immune system. Similarly, specific chemotherapy agents may be associated with increased immune response.
According to those mentioned above, if a person is going to have chemotherapy treatment and there is the option of using different drugs, it is more beneficial to use medicines that positively affect the immune response. In addition, it is essential to take advantage of the potential synergy with immunotherapy.
Without a doubt, it is a complicated process since most oncologists disagree with this combination of therapies; low-dose chemotherapy, also called metronomic dosing, seems more effective when it comes to stimulating an immune response. Unfortunately, this is not the way oncologists usually administer chemotherapy.
Although chemotherapy may be wished to be a memory of the past, it may still have a use, especially in the current situation of immunotherapy. If the patient has advanced cancer with extensive tumors, they might need help using chemotherapy treatment to give them a little more control so the immune system has a chance to fight it off. Otherwise, a rapidly growing advanced cancer may outpace the immune system. Cancer usually has a significant advantage at the beginning, and chemotherapy can slow it down, allowing the immune system to catch up.
It is essential to understand that metronomic chemotherapy is much more recommended since it is low-dose and can achieve many of the objectives of slowing down cancer and boosting the immune response against cancer.
References:
Cómo la quimioterapia afecta el sistema inmunitario. (s. f.). https://www.breastcancer.org/es/organizar-la-vida/sistema-inmunitario/tratamientos-contra-el-cancer/quimioterapia
Williams, J. (2019, 15th October) The Immunotherapy Revolution. Pg 72-75
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