Toll-like receptor immune modulatory role in personalized management of colorectal cancer, review of literature

Abstract

ABSTRACT Colorectal cancer (CRC) is characterized by high heterogeneity and a complex microenvironment that leads to high inter-patient variability. Personalized management of CRC could address this. Accumulating data highlights the interaction between the CRC microenvironment and the immune system through different cells and receptors with a focus on the toll-like receptors (TLRs). Multiple studies identified a bidirectional role played by TLRs in CRC with involvement in both carcinogenesis and therapy. Areas covered A study to highlight the interaction between TLRs and CRC microenvironment on different molecular levels was undertaken, addressing TLR gene polymorphism, TLR genetic and epigenetic deregulation and TLR ligand binders. In addition, the use of these TLRs and their interaction with CRC microenvironment were evaluated to identify novel CRC therapeutics. Expert commentary Previous literature has shown that TLRs are incriminated in CRC pathogenesis and thus research effort was directed to make use of these TLRs in drawing new therapeutic patterns for CRC. However, to date, these immune-therapeutic patterns of CRC have shown limited success in reducing tumor burden. This highlights the need for more studies that would better illustrate the interaction between TLRs and CRC microenvironment and the impact of TLR modifications to yield more efficient and precise CRC therapeutics.