Since
obesity is a major risk factor for many different types of
cancer, examining one of the most closely associated comorbidities, such as
hypercholesterolemia, is crucial to understanding how
obesity causes
cancer.
Hypercholesterolemia is usually associated with many cardiovascular complications such as
hypertension, angina, and
atherosclerosis. In addition,
cholesterol may be a major factor in increasing
cancer risk.
Cancer patients who received
statins, an anti-hypercholesteremic medicine, demonstrated improved prognosis possibly through its effect on
tumor proliferation, apoptosis, and oxidative stress. Cholesterol could also aid in
tumor progression through reprogramming
tumor immunological architecture and mediators. This review focuses on the immunomodulatory role of
cholesterol on cellular and molecular levels, which may explain its oncogenic driving activity. We look at how
cholesterol modulates
tumor immune cells like dendritic cells, T cells, Tregs, and neutrophils. Further, this study sheds light on the modification of the expression pattern of the common
cancer-related immune mediators in the
tumor immune microenvironment, such as programmed cell death 1 (PD-1), cytotoxic T lymphocyte antigen-4 (CTLA-4),
transforming growth factor-beta (TGF-β),
interleukin 12 (IL-12),
IL-23, and
forkhead box protein P3 (FOXP3).
RECENT FINDINGS: We highlight relevant literature demonstrating
cholesterol's immunosuppressive role, leading to a worse
cancer prognosis. This review invites further research regarding the pathobiological role of
cholesterol in many
obesity-related
cancers such as
uterine fibroids, post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and
gallbladder cancers. This review suggests that targeting
cholesterol synthesis may be a fruitful approach to
cancer targeting, in addition to traditional chemotherapeutics.