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“The emerging epidemic of Hodgkin and non-Hodgkin lymphomas worldwide<br />

continues to defy our understanding ...”<br />

Immunology Research • February 2015<br />

Adjuvants and lymphoma risk as part of the ASIA spectrum<br />

Author information<br />

Butnaru D1, Shoenfeld Y.<br />

The Zabludowicz Center for Autoimmune Diseases<br />

Sheba Medical Center, Tel Hashomer, Israel<br />

dana_medis@iberserv.es<br />

Abstract<br />

The emerging epidemic of Hodgkin and non-Hodgkin lymphomas worldwide continues to defy our understanding<br />

and forces the search for the causative factors. Adjuvants are known to act as triggers of immune and inflammatory<br />

responses. Animal experiments have demonstrated that long-term inflammation is related to aggravation<br />

of the immune network resulting in cellular and humoral responses leading to autoimmunity and lymphoma<br />

development. Chronic stimulation of the immune system is thought to be the key mechanism through which<br />

infectious diseases as well as autoimmune diseases can lead to lymphomagenesis. Many adjuvants can act similarly<br />

perturbing immune system’s function, inducing a state of prolonged immune activation related to chronic<br />

lymphatic drainage. Several mechanisms were proposed by which adjuvants induce inflammation, and they are<br />

discussed herein. Some of them are triggering inflammasome; others bind DNA, lipid moieties in cells, induce<br />

uric acid production or act as lipophilic and/or hydrophobic substances. The sustained inflammation increases the<br />

risk of genetic aberrations, where the initial polyclonal activation ends in monoclonality. The latter is the hallmark<br />

of malignant lymphoma. Thus, chronic adjuvant stimulation may lead to lymphoma.<br />

http://www.ncbi.nlm.nih.gov/pubmed/?term=25582758

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