Transformation In Autoimmune Conditions

The association between autoimmune diseases and malignant tumors can be due to a common pathogenic factor inducing the diseases, triggering of malignant transformation by the autoimmune process or due to the treatment. Genetic predisposition is believed to be important both in autoimmune diseases and cancer [113]. Indeed, there are inherited conditions, notably IgA deficiency, which predispose both to autoimmunity and malignancy [114], It is possible that in autoimmune diseases there is immunologic predisposition for the development of malignancies. It has been suggested that the basic defect in SLE, rheumatoid arthritis and other autoimmune conditions is a deficiency in suppressor T-cell function (reviewed in [115]). A deficiency in suppressor T-cell function may lead to unregulated proliferation of B cells and lymphoproliferative malignancies. Another possibility is that the chronic antigenic stimulation of lymphocytes that takes place in autoimmune conditions (e.g., SS) may lead to a population of lymphocytes that are more susceptible to neoplastic transformation. It is not known whether an intrinsic defect in B cells in patients with autoimmune diseases might enhance malignant transformation. The possible role of decreased immune surveillance in the induction of lymphoproliferative diseases in autoimmune conditions is supported by the observation of increased frequency of malignancies in immune deficiency states. Recently, it has been suggested that increased oncogene expression reported in some autoimmune conditions, may induce malignant transformation in these diseases [116-118],

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