4.6 Article

Obesity-induced thymic involution and cancer risk

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SEMINARS IN CANCER BIOLOGY
卷 93, 期 -, 页码 3-19

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ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
DOI: 10.1016/j.semcancer.2023.04.008

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Cancer; Obesity; Thymic Involution; Inflammation; Sex Steroids; Adipokines

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Declining thymic functions, whether due to old age or acute involution caused by stress, infectious disease, or cytoreductive therapies, have been associated with increased cancer risk. Obesity has also been linked to cancer development and progression, with chronic inflammation, hormone production, and hyperinsulinemia as key factors. This study focuses on the molecular and cellular mechanisms of obesity-induced thymic involution as an intermediary pathology leading to cancer, and suggests targeted thymic regeneration strategies for obese individuals at high risk of cancer.
Declining thymic functions associated either with old age (i.e., age-related thymic involution), or with acute involution as a result of stress, infectious disease, or cytoreductive therapies (e.g., chemotherapy/radiotherapy), have been associated with cancer development. A key mechanism underlying such increased cancer risk is the thymus-dependent debilitation of adaptive immunity, which is responsible for orchestrating immunoediting mechanisms and tumor immune surveillance. In the past few years, a blooming set of evidence has intriguingly linked obesity with cancer development and progression. The majority of such studies has focused on obesity -driven chronic inflammation, steroid/sex hormone and adipokine production, and hyperinsulinemia, as prin-cipal factors affecting the tumor microenvironment and driving the development of primary malignancy. However, experimental observations about the negative impact of obesity on T cell development and maturation have existed for more than half a century. Here, we critically discuss the molecular and cellular mechanisms of obesity-driven thymic involution as a previously underrepresented intermediary pathology leading to cancer development and progression. This knowledge could be especially relevant in the context of childhood obesity, because impaired thymic function in young individuals leads to immune system abnormalities, and predisposes to various pediatric cancers. A thorough understanding behind the molecular and cellular circuitries governing obesity-induced thymic involution could therefore help towards the rationalized development of targeted thymic regeneration strategies for obese individuals at high risk of cancer development.

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