Dr. Weeks’ Comment: I recently spoke before a gathering of oncologists and medical colleagues about the double edged sword of inflammation during which clarifying that whereas chronic inflammation contributes to cancer, acute inflammation is therapeutic. Dr. Rudolf Steiner proposed this distinction in 1900 and his students F. Husemann and O. Wolff carried the work further. Here is a relevant insight for your consideration.
“It may be confusing to find it inflammations are fairly regularly found in the area of the tumor. This could, in fact, lead to the erroneous impression that these inflammations have a pathogenic significance in the arising of the tumor. In reality, however, neither simultaneous occurrence nor regular six session implies anything about a causal connection. This can be recognized only on the basis of an essential relation to the whole phenomenon. The inflammation found around the tumor is always of a chronic nature and arises not primarily but as an insufficient reactive attempt by the organism to reincorporated the proliferating parts -living foreign bodies- into the whole by disintegrating them with a febrile inflammation. Husemann/ Wolff p 191
Now we see a modern validation:
Acute pancreatitis is characterized by a predominantly innate immune response, while chronic pancreatitis elicits an immune response that involves both innate and adaptive immune cells, and often results in profound systemic immune-suppression.
My thanks to my wise colleague Dr. Jonathan Miller for sending me this “excellent and edifying paper” Complex role for the immune system in initiation and progression of pancreatic cancer published recently in the World Journal of Gastroenterology.
Complex role for the immune system in initiation and progression of pancreatic cancer.
The immune system plays a complex role in the development and progression of pancreatic cancer. Inflammation can promote the formation of premalignant lesions and accelerate pancreatic cancer development. Conversely, pancreatic cancer is characterized by an immunosuppressive environment, which is thought to promote tumor progression and invasion. Here we review the current literature describing the role of the immune response in the progressive development of pancreatic cancer, with a focus on the mechanisms that drive recruitment and activation of immune cells at the tumor site, and our current understanding of the function of the immune cell types at the tumor. Recent clinical and preclinical data are reviewed, detailing the involvement of the immune response in pancreatitis and pancreatic cancer, including the role of specific cytokines and implications for disease outcome. Acute pancreatitis is characterized by a predominantly innate immune response, while chronic pancreatitis elicits an immune response that involves both innate and adaptive immune cells, and often results in profound systemic immune-suppression. Pancreatic adenocarcinoma is characterized by marked immune dysfunction driven by immunosuppressive cell types, tumor-promoting immune cells, and defective or absent inflammatory cells. Recent studies reveal that immune cells interact with cancer stem cells and tumor stromal cells, and these interactions have an impact on development and progression of pancreatic ductal adenocarcinoma (PDAC). Finally, current PDAC therapies are reviewed and the potential for harnessing the actions of the immune response to assist in targeting pancreatic cancer using immunotherapy is discussed.