GENERAL COMMENTARY article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1641619
This article is part of the Research TopicRisk and Protective Factors in the Natural History of AutoimmunityView all 9 articles
General Commentary: The letter to editor " Cancer in Connective Tissue Disease "
Provisionally accepted
- 1Jiayi Chen, Suzhou, China
- 2(suzhou wujiang district hospital[Affiliation]) AND (jiayi chen[Author]), suzhou, China
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I commend the authors for highlighting the paradoxical role of autoimmunity-where chronic inflammation may promote oncogenesis, yet autoimmune responses can also exert antitumor effects. This duality is exemplified by the contrasting implications of autoantibodies like anti-TIF1-γ (high cancer risk in IIM) and anti-Sp4/CCAR1 (potentially protective). However, I emphasize the urgent need for standardized autoantibody detection methods. As noted, discrepancies in anti-NXP2 results across assays (e.g., line blot vs. immunoprecipitation) complicate clinical interpretation [2]. Harmonizing laboratory techniques is essential to refine risk stratification and validate guidelines like the IMACS cancer-screening algorithm [3]. I also support the call for disease-specific screening frameworks. While IMACS offers a model for IIM, similar protocols are lacking for systemic sclerosis and Sjögren's syndrome, where lymphoma risk escalates with biomarkers like ectopic germinal centers or CXCL13. Tailored strategies must integrate serological, clinical, and imaging data (e.g., salivary gland ultrasound in SS) while balancing cost-effectiveness and accessibility.Finally, the impact of immunosuppressants on cancer risk warrants deeper exploration. Although the review notes inconclusive data on therapies like mycophenolate in systemic sclerosis, real-world studies are needed to clarify risks associated with newer biologics (e.g., rituximab) and the potential protective role of hydroxychloroquine. Pharmacovigilance registries could illuminate these associations.In conclusion, Tonutti et al. have delivered an invaluable review that crystallizes the complex cancer-CTD interplay. Future efforts should prioritize validating autoantibody panels, expanding screening guidelines, and elucidating treatment-related oncogenic risks through international cohorts.
Keywords: Autoantibodies, Autoimmunity, connective tissue disease (CTD), immunology, malignancy
Received: 06 Jun 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiayi Chen, Jiayi Chen, Suzhou, China
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