Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press62610.17650/1726-9776-2017-13-1-20-26DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиRole of tumor-associated macrophages in renal cell carcinoma pathogenesisРоль макрофагов, ассоциированных с опухолью в патогенезе почечно-клеточного ракаKovalevaO. V.КовалеваО. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 24

EfremovG. D.ЕфремовГ. Д.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

efremov.gen@yandex.ruMikhaylenkoD. S.МихайленкоД. С.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

AlekseevB. Ya.АлексеевБ. Я.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

GrachevA. N.ГрачевА. Н.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

Алексей Николаевич Грачев

115478 Москва, Каширское шоссе, 24

alexei.gratchev@gmail.comBlokhin Russian Cancer Research CenterРоссийский онкологический научный центр им. Н.Н. БлохинаNational Medical Research Radiological CenterНациональный медицинский исследовательский радиологический центр3003201713120263110201622122016https://oncourology.abvpress.ru/oncur/article/view/626

The role of tumor stroma in malignant tumor pathogenesis cannot be disputed. Macrophages are one of the crucial elements of tumor stroma. Tumor-associated macrophages (TAMs) are type 2-activated macrophages (M2). They were first described in 1992. They carry CD206, CD163, FXIIIa, βIG-H3, stabilin 1, YKL-39, SI-CLP, tenascin С, LOX-1, fibronectin, MARCO, interleukin 1 receptor antagonist (IL-1RA) and other markers. Unlike proinflammatory macrophages (M1), М2 display high anti-inflammatory activity and are responsible for inflammation reaction suppression and tissue recovery in inflamed area. TAMs significantly contribute to tumor progression by stimulating cell proliferation, angiogenesis, and suppression of antitumor immune response. Identification of macrophages in renal tumors involves a limited number of markers, which doesn’t allow making a conclusive answer about their function. However, a correlation between TAMs content and a negative disease prognosis can be considered proven. Studies of M1 and M2 using different markers have shown that renal tumors contain high levels of TAMs with mixed M1/M2 phenotype. TAMs in renal tumors are highly proangiogenic and immunosuppressive. TAMs density can be used as a prognostic marker, but development of an effective treatment strategy aimed at inhibition of TAMs antitumor activity requires systemic research involving a wide panel of M1 and M2 macrophage markers. 

Роль опухолевой стромы в патогенезе злокачественных опухолей не подвергается сомнению. Макрофаги – одни из ключевых элементов опухолевой стромы. Макрофаги, ассоциированные с опухолью (МАО), являются макрофагами 2-го типа активации (М2), которые впервые были описаны в1992 г. К их маркерам относятся CD206, CD163, FXIIIa, βIG-H3, стабилин 1, YKL-39, SI–CLP, тенасцин С, LOX-1, MARCO, фибронектин, антагонист рецептора интерлейкина 1 (ИЛ-1RA) и др. В отличие от провоспалительных макрофагов (М1) М2 обладают выраженной противовоспалительной активностью и отвечают за подавление воспалительной реакции и восстановление ткани в очаге воспаления. МАО вносят значительный вклад в прогрессию опухолей за счет стимуляции пролиферации клеток, ангиогенеза и подавления противоопухолевого иммунного ответа. Для выявления макрофагов в опухолях почки используют ограниченное количество маркеров, не позволяющих сделать однозначного вывода относительно их функции. Однако несмотря на это, ассоциацию количества МАО с плохим прогнозом заболевания можно считать доказанной. Исследования фенотипа М1 и М2 с использованием их различных маркеров показали, что в опухолях почки присутствует большое количество МАО, имеющих смешанный М1/М2-фенотип. МАО в опухолях почки обладают выраженными проангиогенными и иммуносупрессорными свойствами. Хотя плотность МАО может быть использована в качестве прогностического маркера, необходимы систематические исследования с применением широкой панели маркеров М1 и М2 для разработки эффективной стратегии лечения, направленной на нейтрализацию проопухолевой активности МАО.

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