Philosophy_of_Immunology_by_Thomas_Pradeu_UserUpload.Net

wounds, mechanical pressure, and local modifications due to carcinogenic
environmental factors, among several other causes, can create an abnormal
local context (characterized by inflammation, perturbation of the extracellular
matrix, and so on) (Dolberg et al. 1985; Bissell and Radisky 2001; Mantovani
et al. 2008; Fernández-Sánchez et al. 2015). This local context influences the
immune system, which in turn responds as it usually does, that is, by maintain-
ing or repairing the tissue–even if thefinal, pathological, outcome is cancer
promotion (Figure 4.4). It has long been known, for instance, that tumors

Immune System

Pathogens Wounds

Context

Mechanical

pressure

Controls

Tissue Organization

Decohesion can concern all these mechanisms

Maintains

chronic elements

Eleminates or contains

abnormal cells

Repairs

Figure 4.4 Decohesion in cancer induced by an abnormal context. Immune-
mediated decohesion may be due to an abnormal context rather than an
abnormal immune system. This abnormal context can be due to the presence of
pathogens, wounds, mechanical pressures, and carcinogens of environmental
origins, among many other resources; it can also be triggered by the tumor itself.
In many situations, the decohesion mediated by the immune system results from
abnormal realization of normal processes (such as maintenance and repair).
(Figure drawn by Wiebke Bretting).

Philosophy of Immunology 41