Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy

Oxidative stress, that is, an unbalanced increase in reactive oxygen species (ROS), contributes to tumor-induced immune suppression and limits the efficacy of immunotherapy. Cancer cells have inherently increased ROS production, intracellularly through metabolic perturbations and extracellularly thr...

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Main Authors: Rolf Kiessling, Elias S J Arnér, Aine O’Reilly, Wenchao Zhao, Stina Wickström
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/12/12/e009409.full
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author Rolf Kiessling
Elias S J Arnér
Aine O’Reilly
Wenchao Zhao
Stina Wickström
author_facet Rolf Kiessling
Elias S J Arnér
Aine O’Reilly
Wenchao Zhao
Stina Wickström
author_sort Rolf Kiessling
collection DOAJ
description Oxidative stress, that is, an unbalanced increase in reactive oxygen species (ROS), contributes to tumor-induced immune suppression and limits the efficacy of immunotherapy. Cancer cells have inherently increased ROS production, intracellularly through metabolic perturbations and extracellularly through activation of NADPH oxidases, which promotes cancer progression. Further increased ROS production or impaired antioxidant systems, induced, for example, by chemotherapy or radiotherapy, can preferentially kill cancer cells over healthy cells. Inflammatory cell-derived ROS mediate immunosuppressive effects of myeloid-derived suppressor cells and activated granulocytes, hampering antitumor effector cells such as T cells and natural killer (NK) cells. Cancer therapies modulating ROS levels in tumors may thus have entirely different consequences when targeting cancer cells versus immune cells. Here we discuss the possibility of developing more efficient cancer therapies based on reduction-oxidation modulation, as either monotherapies or in combination with immunotherapy. Short-term, systemic administration of antioxidants or drugs blocking ROS production can boost the immune system and act in synergy with immunotherapy. However, prolonged use of antioxidants can instead enhance tumor progression. Alternatives to systemic antioxidant administration are under development where gene-modified or activated T cells and NK cells are shielded ex vivo against the harmful effects of ROS before the infusion to patients with cancer.
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series Journal for ImmunoTherapy of Cancer
spelling doaj-art-e1494a1e9768405ebe1fce708f6226342025-08-20T02:49:35ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262024-12-01121210.1136/jitc-2024-009409Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapyRolf Kiessling0Elias S J Arnér1Aine O’Reilly2Wenchao Zhao3Stina Wickström4Department of Oncology-Pathology, Karolinska Institutet, Stockholm, SwedenDivision of Biochemistry, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, SwedenDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, SwedenDivision of Biochemistry, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, SwedenDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, SwedenOxidative stress, that is, an unbalanced increase in reactive oxygen species (ROS), contributes to tumor-induced immune suppression and limits the efficacy of immunotherapy. Cancer cells have inherently increased ROS production, intracellularly through metabolic perturbations and extracellularly through activation of NADPH oxidases, which promotes cancer progression. Further increased ROS production or impaired antioxidant systems, induced, for example, by chemotherapy or radiotherapy, can preferentially kill cancer cells over healthy cells. Inflammatory cell-derived ROS mediate immunosuppressive effects of myeloid-derived suppressor cells and activated granulocytes, hampering antitumor effector cells such as T cells and natural killer (NK) cells. Cancer therapies modulating ROS levels in tumors may thus have entirely different consequences when targeting cancer cells versus immune cells. Here we discuss the possibility of developing more efficient cancer therapies based on reduction-oxidation modulation, as either monotherapies or in combination with immunotherapy. Short-term, systemic administration of antioxidants or drugs blocking ROS production can boost the immune system and act in synergy with immunotherapy. However, prolonged use of antioxidants can instead enhance tumor progression. Alternatives to systemic antioxidant administration are under development where gene-modified or activated T cells and NK cells are shielded ex vivo against the harmful effects of ROS before the infusion to patients with cancer.https://jitc.bmj.com/content/12/12/e009409.full
spellingShingle Rolf Kiessling
Elias S J Arnér
Aine O’Reilly
Wenchao Zhao
Stina Wickström
Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
Journal for ImmunoTherapy of Cancer
title Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
title_full Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
title_fullStr Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
title_full_unstemmed Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
title_short Reactive oxygen species: Janus-faced molecules in the era of modern cancer therapy
title_sort reactive oxygen species janus faced molecules in the era of modern cancer therapy
url https://jitc.bmj.com/content/12/12/e009409.full
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