The Inflammatory Microenvironment in Wilms Tumors

ABSTRACT

For the past several decades, the role of inflammation in different types of tumors has been well defined. The significance of inflammation including the presence of various immune cells and inflammatory marker analysis of tumors helped the clinicians to use new treatment methods, which lead to high cure rates but failed to do so in some tumors due to lack of information about the tumor microenvironment. Although the importance of inflammation in various adult malignancies has been well defined, by contrast, Wilms tumor (WT), the most common childhood kidney cancer, which represents 6% of all pediatric tumors, has not been well studied. Nearly 75% of the WT cases have been noticed in children less than 5 years of age with a higher incidence at 2 to 3 years. Thus, very little is known about the inflammatory microenvironment in the development of WT. This inflammatory microenvironment may initiate oncogenic transformation, and in some instances, genetic and epigenetic modifications in tumor cells can also generate an inflammatory microenvironment that further supports tumor progression. Thus, the tumor microenvironment is highly dynamic, and linking the modulating factors and various inflammatory cells with tumor progression is of considerable interest. Although to some extent the currently used WT treatment methods such as surgical removal, chemotherapy, and radiation therapy are successful, the youngest children are at high risk for the irreversible adverse side effects. Thus, there is a need for alternative therapy/therapies exposing the child to the minimum possible adverse effects. This chapter gives a special focus on the inflammatory microenvironment of human WT with a comprehensive picture of various immune cells and other inflammatory markers. This may aid in the use of new therapeutic targets for the efficacious treatment of WT with the combination of currently adapted therapies or alone.