| Autor: |
Maffini F; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Lepanto D; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Chu F; Division of Otolaryngology Head and Neck Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy., Tagliabue M; Division of Otolaryngology Head and Neck Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy.; Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy., Vacirca D; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., De Berardinis R; Division of Otolaryngology Head and Neck Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy., Gandini S; Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Vignati S; Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Ranghiero A; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Taormina S; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Rappa A; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Cossu Rocca M; Medical Oncology Division of Urogenital and Head and Neck Tumors, European Institute of Oncology IRCCS, 20141 Milan, Italy., Alterio D; Department of Radiotherapy, European Institute of Oncology IRCCS, 20141 Milan, Italy., Chiocca S; Department of Experimental Oncology, European Institute of Oncology IRCCS, 20139 Milan, Italy., Barberis M; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy., Preda L; Diagnostic Imaging Unit, National Center of Oncological Hadron-Therapy (CNAO), 27100 Pavia, Italy.; State University School of Medicine, University of Pavia, 27100 Pavia, Italy., Pagni F; Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, 20126 Milan, Italy., Fusco N; Department of Surgical Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy.; State University School of Medicine, University of Milan, 20122 Milan, Italy., Ansarin M; Division of Otolaryngology Head and Neck Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy. |
| Abstrakt: |
This article describes how the transcriptional alterations of the innate immune system divide dysplasias into aggressive forms that, despite the treatment, relapse quickly and more easily, and others where the progression is slow and more treatable. It elaborates on how the immune system can change the extracellular matrix, favoring neoplastic progression, and how infections can enhance disease progression by increasing epithelial damage due to the loss of surface immunoglobulin and amplifying the inflammatory response. We investigated whether these dysregulated genes were linked to disease progression, delay, or recovery. These transcriptional alterations were observed using the RNA-based next-generation sequencing (NGS) panel Oncomine Immune Response Research Assay (OIRRA) to measure the expression of genes associated with lymphocyte regulation, cytokine signaling, lymphocyte markers, and checkpoint pathways. During the analysis, it became apparent that certain alterations divide dysplasia into two categories: progressive or not. In the future, these biological alterations are the first step to provide new treatment modalities with different classes of drugs currently in use in a systemic or local approach, including classical chemotherapy drugs such as cisplatin and fluorouracile, older drugs like fenretinide, and new checkpoint inhibitor drugs such as nivolumab and pembrolizumab, as well as newer options like T cell therapy (CAR-T). Following these observed alterations, it is possible to differentiate which dysplasias progress or not or relapse quickly. This information could, in the future, be the basis for determining a close follow-up, minimizing surgical interventions, planning a correct and personalized treatment protocol for each patient and, after specific clinical trials, tailoring new drug treatments. |
