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'The Obesity Paradox': Enhancing Immunotherapy Strategies

The Health Survey for England (2021) shows that over 25% of the UK's population are classified as obese, with a Body Mass Index (BMI) of 30 or above.

Obesity is recognised to be the second leading modifiable risk for cancer behind smoking, with the Health Survey for England (2021) revealing that over 25% of the UK’s population are classified as obese – usually defined as having a Body Mass Index (BMI) of 30 or above.

The research team from Vanderbilt University Medical Centre in the United States, through the scientific journal “Nature” (12 June 2024), released the results of their study showing that obesity may improve responses to immunotherapy – a new way of treating cancer which stimulates the bodies’ immune response, helping the body to recognise and attack cancer cells.

The researchers found an increased frequency of macrophages in the tumours of obese patients which induced the expression of an immune checkpoint protein, PD-1, which is a target for immunotherapies.

In simple terms, an increased PD-1 expression both suppresses immune surveillance and subsequent “killer” T-cells allowing tumours to grow. Blockage of PD-1, expressing macrophages with immunotherapy, enhances the immune response, though this was found to work only in between 20% and 30% of patients, indicating that examining the levels of PD-1 expressing tumour macrophages may help identify patients who will respond better to immunotherapy.

  

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