Lymphoma and autoimmunity

Lymphoma and other hematologic malignancies ('blood cancers') have been shown be previous investigators to be linked to autoimmunity. The authors of a paper just published in the Journal of Autoimmunity illustrate how epigenetic mechanisms can imbalance immune function in a way that contributes to both autoimmunity and hematologic malignancies such has lymphoma, leukemia, etc. They observe:

"The relationships between immunological dysfunction, loss of tolerance and hematologic malignancies have been a focus of attention in attempts to understand the appearance of a higher degree of autoimmune disease and lymphoma in children with congenital immunodeficiency...In particular, accumulating evidence is defining a role of epigenetic mechanisms as being critical in this continuous spectrum between autoimmunity and lymphoma."

They offer these highlights:

• Immune dysregulation leads to autoimmune diseases and hematologic malignancies.
• Incidence of autoimmunity and lymphoma is high in primary immunodeficiencies.
• Epigenetic mechanisms play a major role in dysregulation of Th17/Treg homeostasis.
• Tregs and Th17 imbalance contributes to autoimmunity and hematologic malignancies.

They point out in particular that imbalances in T helper 17 (Th17) and T regulatory populations can alter local microenvironments that change the expression of genetic transcription factors involved in cell activation and differentiation. Environmental factors that modify genetic expression (epigenetic factors) are known to promote the loss of self-tolerance that defines autoimmunity. Furthermore, attack on self tissue is often characterized by an imbalance between T helper 17 (Th17) and T regulatory cells. The authors also state:

"Abnormal expression in any of the molecules involved in Th17 and/or Treg development alter immune homeostasis and in genetically susceptible hosts may lead to the appearance of autoimmunity and/or lymphoma."

Clinicians participating in the case management of lymphoma and other blood cancers should thoroughly consider the autoimmune aspect when designing treatment plans that address underlying causes.