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Tumor Interstitial Fluid (TIF) from bench to bedside

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The tumor interstitial fluid (TIF) is an interesting object of research, able to explain the various changes that occur within the tumor stroma. From the time of Gullino and Sylven many aspects of its physiology and biochemistry have changed. The same physiological laws that regulate the exchange of fluid ...

The tumor interstitial fluid (TIF) is an interesting object of research, able to explain the various changes that occur within the tumor stroma. From the time of Gullino and Sylven many aspects of its physiology and biochemistry have changed. The same physiological laws that regulate the exchange of fluid between the vascular bed and the interstitium have been better analysed and clarified. The TIF, when properly collected, proves to be a valuable liquid to identify tumor markers. This last aspect has been studied intensely, especially with the advent of proteomics. It seems useful to analyse this important aspect of the pathophysiology of cancer from all points of view - from pathophysiology to proteomics to clinical applications.

To expand our knowledge there is also something interesting on new aspects related to carcinogenesis such as the contribution of the increase of the pressure that can induce inflammation that should be taken into consideration.

Last but not least, the importance of interstitial fluid pressure (TIFP) and the stroma structure in obstructing the release of drugs (including immune - competent cells and monoclonal antibodies) to the tumor has to be reconsidered. The solutions experimentally found to modify TIFP, and the stroma are to be transported into clinics, permitting so to give practical methods to clinicians. In a sense, we think giving a series of news or media that quickly allows the clinician to use the knowledge directly at the bedside. In any case, it is a common feeling that much experimental knowledge takes too long in their application.

Our intention is to collect a series of articles that can help us understand the physiological aspects of the interstitial fluid, the applicability of this knowledge to the tumor (pathophysiological aspects), the use of this liquid as a potential source of cancer biomarkers and the means (nutritional, physical and pharmacological) able to change it. Regarding the nutritional aspects we refer mainly to the use of fatty acids of marine origin (w-3 FAs). The omega-3 in addition to being a source of energy unwelcome by the tumor represent a means clinical easily applicable. The same conclusions regard hyperthermia, a treatment, avoided of side effects.

Further studies on similar procedures are desirable. Another aspect that should be better understood is how much responsibility can be attributed to the inflammatory reaction about TIF formation, pressure and the vicious circle that is triggered. Recently a new therapeutic strategy has been introduced by Rakesh Jain - an attempt to normalize the tumor vascularization through anti-angiogenic agents. This strategy can decrease the tumor hypoxia to increase the release of drugs, to normalize the interstitial pressure and increase the immune response. In most, this therapeutic strategy should be able to normalize also the behaviour of the lymphatic system that in the tumor area is modified. These aspects are new and sensitive, and we hope to succeed in our plan of sharing the abundant literature on the processes of TIF genesis and on its effects on therapy promoting cross-talk and accelerating discoveries clinically useful.


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