Hypoxia
characterizes solid tumors; it is a stress factor that might cause cells to release DAMPs. These ligands activate TLR signals and contribute to the aberrant molecular pattern in the tumor microenvironment. The TLR contribution Small molecule library purchase to tumor angiogenesis has been investigated in H. pylori-associated gastric cancer [44]. This study reported that H. selleck screening library pylori-induced COX-2 expression and PGE2 release enhanced tumor angiogenesis via TLR2 and 9. Another in vitro study found a direct endothelial stimulatory role for LPS in initiating angiogenesis through activation of TLR signaling pathways [45]. HMGB1 has been recently recognized as a pro-angiogenic factor [46]. HMGB1 upregulation induces the production Selleck CYT387 of VEGF and endothelial cell proliferation. Moreover, HMGB1 acts on endothelial progenitor cells and hematopoietic stem cells to improve neovascularization of injured or malignant tissue [46]. However, other studies show an anti-angiogenic effect for TLRs. In a colorectal cancer xenograft model, a TLR9 agonist reportedly interfered with EGFR signaling and tumor angiogenesis and had a synergistic effect
with other EGFR inhibitors [47]. Imiquimod, a TLR7 agonist used as a topical immune-response modifier in patients with skin cancers, can inhibit tumor angiogenesis [48] by inducing anti-angiogenic cytokines such as IFNs, IL-10 and IL-12; down-regulating pro-angiogenic factors such as fibroblast growth factor β (FGFβ) and metalloproteinase-9 (MMP9); and promoting endothelial cell apoptosis [49].
Although the TLR contribution to tumor angiogenesis remains unclear, interaction with ligands and TLRs seems to have a major role in tumor angiogenesis and hypoxia in tumor microenvironment, which supports tumor growth. DAMPs Released from Injured or Necrotic Cancer Cells Under normal conditions, scheduled cell death is regulated by adenosine triphosphate (ATP) and related apoptotic pathway factors; this regulation drives fragmentation of cellular macromolecules and the speedy subsequent phagocytosis and clearance of apoptotic debris. However, in cancerous conditions, cells dying by non-apoptotic pathways, principally necrosis, release DAMPs into the extracellular space. DAMPs are nuclear or cytosolic Branched chain aminotransferase proteins with defined intracellular functions but different extracellular actions after cytolysis. DAMPs released from injured or dying cells are recognized by TLRs on immune cells; subsequent TLR signals disrupt the anti-tumor immune response and lead to cancer progression [18]. Candidate DAMPs include heat shock proteins (HSP 60, 70), ATP and uric acid, the S100 family of calcium modulated proteins, nuclear protein high-mobility group box 1 (HMGB1), and nucleic acids. HMGB1, a DNA binding protein, is one of the best-characterized DAMP. HMGB1 regulates intracellular transcription and mediates extracellular proinflammatory processes.