1. Sepsis and Cancer: An Interplay of Friends and Foes
- Author
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Elie Azoulay, Jean-François Llitjos, Djamel Mokart, Jean-Daniel Chiche, Clara Vigneron, Adrien Mirouse, Jean-Paul Mira, and Frédéric Pène
- Subjects
Pulmonary and Respiratory Medicine ,business.industry ,medicine.medical_treatment ,Cancer ,Immunosuppression ,Comorbidity ,Critical Care and Intensive Care Medicine ,medicine.disease ,Bioinformatics ,Pathophysiology ,Bacterial sepsis ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,030228 respiratory system ,Risk Factors ,Neoplasms ,medicine ,Humans ,Tumor growth ,030212 general & internal medicine ,Immune homeostasis ,business - Abstract
Sepsis and cancer share a number of pathophysiological features, and both result from the inability of the host's immune system to cope with the initial insult (tissue invasion by pathogens and malignant cell transformation, respectively). The common coexistence of both disorders and the profound related alterations in immune homeostasis raise the question of their mutual impact on each other's course. This translational review aims to discuss the interactions between cancer and sepsis supported by clinical data and the translation to experimental models. The dramatic improvement in cancer has come at a cost of increased risks of life-threatening infectious complications. Investigating the long-term outcomes of sepsis survivors has revealed an unexpected susceptibility to cancer long after discharge from the ICU. Nonetheless, it is noteworthy that an acute septic episode may harbor antitumoral properties under particular circumstances. Relevant double-hit animal models have provided clues to whether and how bacterial sepsis may impact malignant tumor growth. In sequential sepsis-then-cancer models, postseptic mice exhibited accelerated tumor growth. When using reverse cancer-then-sepsis models, bacterial sepsis applied to mice with cancer conversely resulted in inhibition or even regression of tumor growth. Experimental models thus highlight dual effects of sepsis on tumor growth, mostly depending on the sequence of insults, and allow deciphering the immune mechanisms and their relation with microorganisms.
- Published
- 2020
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