Malignant inflammation in cutaneous T-cell lymphoma: a hostile takeover

Cutaneous T-cell lymphomas (CTCL) are characterized by the presence of chronically inflamed skin lesions containing malignant T cells. Early disease presents as limited skin patches or plaques and exhibits an indolent behavior. For many patients, the disease never progresses beyond this stage, but in approximately one third of patients, the disease becomes progressive, and the skin lesions start to expand and evolve. Eventually, overt tumors develop and the malignant T cells may disseminate to the blood, lymph nodes, bone marrow, and visceral organs, often with a fatal outcome. The transition from early indolent to progressive and advanced disease is accompanied by a significant shift in the nature of the tumor-associated inflammation. This shift does not appear to be an epiphenomenon but rather a critical step in disease progression. Emerging evidence supports that the malignant T cells take control of the inflammatory environment, suppressing cellular immunity and anti-tumor responses while promoting a chronic inflammatory milieu that fuels their own expansion. Here, we review the inflammatory changes associated with disease progression in CTCL and point to their wider relevance in other cancer contexts. We further define the term "malignant inflammation" as a pro-tumorigenic inflammatory environment orchestrated by the tumor cells and discuss some of the mechanisms driving the development of malignant inflammation in CTCL

Glucocorticoids regulate the expression of the stressprotein alpha B-crystallin

alpha B-crystallin is a major component of the eye lens but is also found in many extralenticular tissues. In established fibroblasts it is synthesized in response to stress such as hyperthermia. Here we report that the treatment of NIH3T3 fibroblasts with the synthetic glucocorticoid hormone dexamethasone resulted in the accumulation of substantial amounts of alpha B-crystallin, alpha B-crystallin mRNA accumulated slowly and over a period of many days in response to prolonged hormone treatment. alpha B-crystallin promoter-reporter constructs were hormone responsive. A putative glucocorticoid response element (GRE) within the analysed promoter region could bind the glucocorticoid receptor as revealed from in vitro footprint analysis but is not involved in the hormone-mediated gene activation. Deletions of 5' flanking regions to position -465 relative to the transcription start allowed for full hormone responsiveness. A deletion from -465 to -389 abolish hormone-mediated gene induction. No sequence element closely resembling a classical GRE is present within that hormone-responsive region