To summarize the multifaceted impact of obesity on the metabolic and immune environment in renal cell carcinoma (RCC), particularly clear cell RCC (ccRCC), emphasizing its complexity beyond mere fat accumulation.
Approach:
Key Findings:
Obesity transforms the renal tumor microenvironment, promoting tumor growth and immunosuppression through specific metabolic pathways.
Increased levels of leptin, resistin, IL-1β, IL-6, IL-8, and VEGF, alongside decreased adiponectin and omentin-1, contribute to angiogenesis and immune evasion, impacting treatment efficacy.
Obesity reshapes the immune environment, leading to T cell exhaustion and increased regulatory T cells, which complicates therapeutic responses.
Interpretation:
The findings highlight the intricate relationship between obesity and RCC, suggesting that obesity influences both tumor biology and treatment responses, necessitating further research into targeted interventions.
Limitations:
Variability in body mass index as a biological indicator of obesity may obscure true metabolic impacts.
Differences in systemic inflammation and body composition among RCC cohorts could affect the generalizability of findings.
Conclusion:
The study emphasizes the urgent need for obesity-relevant preclinical models and clinical trials targeting immunometabolism in RCC to improve patient outcomes.
