Balkwill and Mantovani 2001: inflammation and cancer, back to Virchow?
A short, widely cited essay reviving Virchow's 1863 observation that tumours are full of white blood cells, arguing that the inflammatory cells and cytokines in tumours help them grow rather than fight them.
Overview
Balkwill and Mantovani revisited Rudolf Virchow's observation of leukocytes in tumours and assembled the modern evidence: that chronic inflammatory conditions predispose to cancer, that tumours recruit macrophages and other inflammatory cells whose cytokines and chemokines promote growth, angiogenesis and invasion, and that inflammatory mediators such as TNF, IL-1 and IL-6 have tumour-promoting roles. They noted the reduced colorectal cancer risk in long-term users of non-steroidal anti-inflammatory drugs as clinical support and proposed anti-inflammatory strategies for prevention and treatment.
- Chronic inflammation predisposes to cancer and tumours themselves recruit inflammatory cells.
- Cytokines and chemokines from tumour-associated leukocytes promote proliferation, angiogenesis and invasion.
- Long-term NSAID use is associated with lower colorectal cancer risk, supporting the causal link.
Together with the 2002 Nature review this essay put inflammation on the cancer research agenda; the tumour-associated macrophage and IL-6 work that followed, and the aspirin prevention trials, trace back to it.
- An essay rather than a systematic review.
- Distinguishing tumour-promoting from tumour-fighting inflammation remains a central challenge.
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