Principles of cuntaneous immunology and immunotherapy is effective in skin cancer

Stephan Grabbe, MD of the University Medical Center, Johannnes Gutenberg University Mainz, Mainz, Germany discuses cutaneous immunology at the 2016 World Congress on Cancers of the Skin (WCCS) and the Congress of the European Association of Dermato-Oncology (EADO) in Vienna, Austria. Prof. Grabbe starts by explaining that clinical experience shows that, for example, metastatic disease in the skin and also primary skin cancer is sensitive to immunotherapy. Local immune response within the skin seems to be somewhat special compared to other sites such as the liver or the lung or other organs. When the composition of the skin immune system is looked at, there is both an abundance of different immune cells as well as specialized cell types that are only found in the skin, such as specialized dendritic cell subsets, specialized T-cell subsets and cells like mast cells and other cells of the innate immune system. He explains that the immune system can be divided into amplifiers that send danger or altered self (in this case tumour antigens) that get activated by pattern recognition receptor ligands, and then effector cells that actually kill tumor cells or other cells or infectious agents. Both these sensors of the immune system that amplify the response and then stimulate more effectively these effector cells, are very abundant both in number and diversity within the skin. He believes that the special composition of the skin immune system is what leads to a better outcome in terms of immunotherapy.

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