Journal
FRONTIERS IN IMMUNOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.994053
Keywords
myelodysplastic syndrome; immune dysregulation; Yin-Yang theory; different risk stratification; immunotherapy
Categories
Funding
- Project entrusted by National Clinical Medical Research Center for Hematological Diseases
- Innovation base and talent plan of Gansu Province
- Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital
- [2021WWA01]
- [21JR7RA435]
- [CY2019-MS14]
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Immune dysregulation plays a crucial role in the pathogenesis of MDS, and different risk stratifications of MDS exhibit distinct immune function changes. Immunotherapy shows varying efficacy in treating different risk MDS.
Myelodysplastic syndrome (MDS) is a heterogeneous group of myeloid clonal diseases with diverse clinical courses, and immune dysregulation plays an important role in the pathogenesis of MDS. However, immune dysregulation is complex and heterogeneous in the development of MDS. Lower-risk MDS (LR-MDS) is mainly characterized by immune hyperfunction and increased apoptosis, and the immunosuppressive therapy shows a good response. Instead, higher-risk MDS (HR-MDS) is characterized by immune suppression and immune escape, and the immune activation therapy may improve the survival of HR-MDS. Furthermore, the immune dysregulation of some MDS changes dynamically which is characterized by the coexistence and mutual transformation of immune hyperfunction and immune suppression. Taken together, the authors think that the immune dysregulation in MDS with different risk stratification can be summarized by an advanced philosophical thought Yin-Yang theory in ancient China, meaning that the opposing forces may actually be interdependent and interconvertible. Clarifying the mechanism of immune dysregulation in MDS with different risk stratification can provide the new basis for diagnosis and clinical treatment. This review focuses on the manifestations and roles of immune dysregulation in the different risk MDS, and summarizes the latest progress of immunotherapy in MDS.
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