Clear Cell Renal Cell Carcinoma Clinical Trial
Official title:
Value of Various Chemokines in the Detection and Follow up of RCC
This study was designed as a pilot study to try and find a Chemokine that may be specific for renal cell carcinoma
I n previous studies that were initiated in experimental models of different inflammatory
autoimmune diseases and then extended to humans, we have shown that in the course of
inflammatory autoimmune diseases, the immune system selectively generates an auto-Ab
response to a few inflammatory mediators, mostly chemokines and cytokines, which are thought
to participate in promoting the inflammatory process (1-6). For example, we showed that
patients suffering from rheumatoid arthritis (RA) but not osteoarthritis display a
significant level of neutralizing auto- Abs directed against TNF-a (tumor necrosis
factor)(3). These patients did not mount any auto-Ab response either to several key
inflammatory chemokines or to regulatory mediators, such as IL-10(interleukin-10) or
TGF-b(tumor growth factor)(, or even the chemokine CXCL12(C-X-C motif chemokine 12), which
also functions as a regulatory mediator that selects Ag-specific IL-10-producing
CD4+(cluster of differentiation 4) T cells (7).
Complementary experiments suggested that in experimentally induced RA, these anti-TNF-a
auto-Abs participate in the natural regulation of disease and restrain—although they are
incapable of totally preventing—its development (3). Nevertheless, their selective
amplification by targeted DNA vaccines led to rapid recovery from an ongoing disease (8).
These studies also showed that selective breakdown of tolerance to TNF-a is due to its
preferential expression at a partially immune-restricted site undergoing a destructive
process (3, 8). Very recently, we have shown that type I diabetes mellitus (T1DM) patients
preferentially display auto-Ab production to CCL3( Chemokine (C-C motif) ligand 3) and not
to several other proinflammatory chemokines (9).
It is yet to be proven that this chemokine dominates the chemokine expression at the
autoimmune site. Nevertheless, a previous study showing that selective neutralization of
CCL3 suppresses T1DM in NOD mice has implications for the important role of this chemokine
in this disease (10). Similarly to organ-specific autoimmunity in various cancer diseases,
one of which is cancer of the prostate (CaP), key inflammatory chemokines are expressed at
the primary tumor site, which also undergoes a destructive process at a restricted site. In
a previous study we showed that in primary tumor sections of prostate cancer subjects,
CCL2Chemokine (C-C motif) ligand 2) is predominantly expressed at the tumor site over other
chemokines that also have been associated with tumor development, including: CXCL12, CXCL10,
CXCL8, CCL3,CCL4, and CCL5. Subsequently, the immune response selectivity mounts an Ab-based
response to CCL2. These Abs are neutralizing Abs. These findings hold diagnostic and
therapeutic implications.
Little is known about the possible function of chemokine receptors in the development and
progression of renal cell carcinoma (RCC). Few studies exist dealing with gene expression of
chemokines in RCC. We therefore suggest a study checking antibody response to a few
chemokines
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