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lüll Targeting inflammatory pathways for tumor radiosensitization Deorukhkar A; Krishnan SBiochem Pharmacol 2010[Dec]; 80 (12): 1904-14Although radiation therapy (RT) is an integral component of treatment of patients with many types of cancer, inherent and/or acquired resistance to the cytotoxic effects of RT is increasingly recognized as a significant impediment to effective cancer treatment. Inherent resistance is mediated by constitutively activated oncogenic, proliferative and anti-apoptotic proteins/pathways whereas acquired resistance refers to transient induction of proteins/pathways following radiation exposure. To realize the full potential of RT, it is essential to understand the signaling pathways that mediate inducible radiation resistance, a poorly characterized phenomenon, and identify druggable targets for radiosensitization. Ionizing radiation induces a multilayered signaling response in mammalian cells by activating many pro-survival pathways that converge to transiently activate a few important transcription factors (TFs), including nuclear factor kappa B (NF-kappaB) and signal transducers and activators of transcription (STATs), the central mediators of inflammatory and carcinogenic signaling. Together, these TFs activate a wide spectrum of pro-survival genes regulating inflammation, anti-apoptosis, invasion and angiogenesis pathways, which confer tumor cell radioresistance. Equally, radiation-induced activation of pro-inflammatory cytokine network (including interleukin (IL)-1beta, IL-6 and tumor necrosis factor-alpha) has been shown to mediate symptom burden (pain, fatigue, local inflammation) in cancer patients. Thus, targeting radiation-induced inflammatory pathways may exert a dual effect of accentuating the tumor radioresponse and reducing normal tissue side-effects, thereby increasing the therapeutic window of cancer treatment. We review recent data demonstrating the pivotal role played by inflammatory pathways in cancer progression and modulation of radiation response.|*Radiation Tolerance/drug effects[MESH]|Animals[MESH]|Cyclooxygenase 2/physiology[MESH]|Cytokines/metabolism[MESH]|Disease Progression[MESH]|Humans[MESH]|Inflammation/metabolism/prevention & control[MESH]|Molecular Targeted Therapy[MESH]|NF-kappa B/physiology[MESH]|Neoplasms/immunology/pathology/*radiotherapy[MESH]|Radiation Injuries/prevention & control[MESH]|STAT Transcription Factors/physiology[MESH] |