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Review
. 2020 Sep;86(9):1726-1735.
doi: 10.1111/bcp.14351. Epub 2020 Jun 3.

Radiation therapy and the innate immune response: Clinical implications for immunotherapy approaches

Valentí Gómez  1   2 , Rami Mustapha  3   4 , Kenrick Ng  1   5 , Tony Ng  1   2   3   4
Affiliations
Review

Radiation therapy and the innate immune response: Clinical implications for immunotherapy approaches

Valentí Gómez et al. Br J Clin Pharmacol. 2020 Sep.

Abstract

Radiation therapy is an essential component of cancer care, contributing up to 40% of curative cancer treatment regimens. It creates DNA double-strand breaks causing cell death in highly replicating tumour cells. However, tumours can develop acquired resistance to therapy. The efficiency of radiation treatment has been increased by means of combining it with other approaches such as chemotherapy, molecule-targeted therapies and, in recent years, immunotherapy (IT). Cancer-cell apoptosis after radiation treatment causes an immunological reaction that contributes to eradicating the tumour via antigen presentation and subsequent T-cell activation. By contrast, radiotherapy also contributes to the formation of an immunosuppressive environment that hinders the efficacy of the therapy. Innate immune cells from myeloid and lymphoid origin show a very active role in both acquired resistance and antitumourigenic mechanisms. Therefore, many efforts are being made in order to reach a better understanding of the innate immunity reactions after radiation therapy (RT) and the design of new combinatorial IT strategies focused in these particular populations.

Keywords: damage-associated molecular patterns; dendritic cells; immunotherapy; innate and adaptive immunity; myeloid-derived suppressor cells; natural killer cells; radiation therapy; tumour-associated macrophages.

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Conflict of interest statement

The authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Effect of radiation therapy (RT) over the innate immune system. RT causes tumour cell death and damage‐associated molecular pattern (DAMP) release. These signals (grey circles: interferon [IFN]‐I, IFN‐γ, transforming growth factor‐β [TGF‐β], tumour necrosis factor‐α [TNF‐α], colony stimulating factor‐1 [CSF1], inducible nitric oxide synthase [iNOS], CXCL6 among many others) trigger both antitumourigenic (blue boxes) and protumourigenic (red boxes) effects in the different components of the innate immune system: dendritic cells, macrophages, myeloid‐derived suppressor cells (MDSC) and natural killer (NK) cells
See this image and copyright information in PMC

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