Immunopathogenesis of ovarian cancer

Immune cells in the ovarian stromal microenvironment play an important role in ovarian tumorigenesis. Up-regulation of immune cell-derived mediators during ovulation may generate a proinflammatory niche, which may subsequently induce transformation of normal ovarian epithelial cells or endometriotic cells in the ovary. Once transformed ovarian epithelial cells develop, an immunoediting process occurs in which immune cells and their mediators dictate the development and progression of ovarian tumors. Tumor cells also develop several mechanisms to evade anti-tumor immunity by developing an immunosuppressive microenvironment. The differences in the population of immune cells infiltrating into ovarian tumor tissues are associated with differences in clinical outcomes. The underlying molecular mechanisms of the association begin to unravel with the development of microdissection techniques, high throughput technologies, in vitro functional assays, and in vivo mouse modeling. A better understanding of the complex relationship between ovarian tumor cells and the associated immune cells will allow us to develop novel immunologic strategies for ovarian cancer prevention and treatment.