Toll-Like Receptor-4 Modulation for Cancer Immunotherapy

Toll-like receptors (TLRs) are evolutionarily conserved pattern recognition molecules. Since the discovery of the Toll pathway cascade (1, 2), our knowledge about the structure, function, and mechanics of TLRs in infectious and inflammatory conditions has increased remarkably. The role of TLR4 as a pathogen-pattern recognition receptor has been studied extensively. We now know that TLR4 recognizes pathogen-associated molecular patterns (PAMPs), such as Gram-negative bacterial lipopolysaccharide (LPS) and endogenous damage-associated molecular patterns (DAMPs) like fibronectin and hyaluronan, which are released during infectious and non-infectious inflammatory conditions. Some chronic infections and inflammatory conditions are known to promote carcinogenesis. For example, Helicobacter pylori (3) and viral hepatitis (4) infections lead to gastric and liver cancers, respectively. Also, in inflammatory bowel disease, non-infectious inflammation promotes the development of colorectal cancer (5). Evidence from recent reports suggests that increased expression and activity of TLR4 in chronic infectious and inflammatory conditions is associated with cancer progression (6–8). At the same time, additional studies suggest the protective role of TLR4 in cancer (9–14). The role of TLR4 in cancer has only recently been studied. This review article provides a brief summary of the current understanding of TLR4-signaling, its pro- and anti-cancer effects, and the therapeutic potential of TLR4 immunomodulation in the prevention and treatment of cancer.

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