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Int. J. Mol. Sci. 2017, 18(8), 1787;

Dysfunctional Natural Killer Cells in the Aftermath of Cancer Surgery

Centre for Innovative Cancer Research, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1H 8M5, Canada
Deeley Research Centre, BC Cancer Agency, Victoria, BC V8R 6V5, Canada
Department of Surgery, University of Ottawa, Ottawa, ON K1H 8L6, Canada
Author to whom correspondence should be addressed.
Received: 25 July 2017 / Revised: 13 August 2017 / Accepted: 14 August 2017 / Published: 17 August 2017
(This article belongs to the Special Issue Natural Killer (NK) Cells)
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The physiological changes that occur immediately following cancer surgeries initiate a chain of events that ultimately result in a short pro-, followed by a prolonged anti-, inflammatory period. Natural Killer (NK) cells are severely affected during this period in the recovering cancer patient. NK cells play a crucial role in anti-tumour immunity because of their innate ability to differentiate between malignant versus normal cells. Therefore, an opportunity arises in the aftermath of cancer surgery for residual cancer cells, including distant metastases, to gain a foothold in the absence of NK cell surveillance. Here, we describe the post-operative environment and how the release of sympathetic stress-related factors (e.g., cortisol, prostaglandins, catecholamines), anti-inflammatory cytokines (e.g., IL-6, TGF-β), and myeloid derived suppressor cells, mediate NK cell dysfunction. A snapshot of current and recently completed clinical trials specifically addressing NK cell dysfunction post-surgery is also discussed. In collecting and summarizing results from these different aspects of the surgical stress response, a comprehensive view of the NK cell suppressive effects of surgery is presented. Peri-operative therapies to mitigate NK cell suppression in the post-operative period could improve curative outcomes following cancer surgery. View Full-Text
Keywords: Natural Killer (NK) cells; surgery; immunosuppression; peri-operative therapies; immunity; immunotherapy Natural Killer (NK) cells; surgery; immunosuppression; peri-operative therapies; immunity; immunotherapy

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Angka, L.; Khan, S.T.; Kilgour, M.K.; Xu, R.; Kennedy, M.A.; Auer, R.C. Dysfunctional Natural Killer Cells in the Aftermath of Cancer Surgery. Int. J. Mol. Sci. 2017, 18, 1787.

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