Immunological basis in the pathogenesis and treatment of bladder cancer

Expert Rev Clin Immunol. 2015 Feb;11(2):265-79. doi: 10.1586/1744666X.2015.983082. Epub 2014 Nov 13.


The pathogenesis and transition of normal urothelium into bladder carcinoma are multifactorial processes. Chronic inflammation causes initiation and progression of the underlying pathophysiology of invasive and metastatic cancer. A dichotomy is observed in the role of immune cells in bladder cancer. While the immune response defends the host by suppressing neoplastic growth, several immune cells, including neutrophils, macrophages and T-lymphocytes, promote tumor development and progression. The levels of human neutrophil peptide-1, -2 and -3, produced by neutrophils, increase in bladder cancer and might promote tumor angiogenesis and growth. The effect of macrophages is primarily mediated by pro-inflammatory cytokines, IL-6 and TNF-α. In addition, the underlying immunological mechanisms of two treatments, BCG and cytokine gene-modified tumor vaccines, and future directions are critically discussed.

Keywords: BCG; T cells; bladder cancer; dendritic cells; macrophages; neutrophils; tumor vaccines; urothelial cell carcinoma.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cancer Vaccines* / genetics
  • Cancer Vaccines* / immunology
  • Cancer Vaccines* / therapeutic use
  • Humans
  • Interleukin-6 / immunology
  • Leukocytes* / immunology
  • Leukocytes* / pathology
  • Mycobacterium bovis*
  • Tumor Necrosis Factor-alpha / immunology
  • Urinary Bladder Neoplasms* / immunology
  • Urinary Bladder Neoplasms* / pathology
  • Urinary Bladder Neoplasms* / therapy
  • alpha-Defensins / immunology


  • Cancer Vaccines
  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • alpha-Defensins