Summary and future considerations

It is clear that a better understanding of our immune system and the way it can differentiate between self-antigens and non-self-antigens will have a huge impact on different areas of clinical medicine. Such developments could help treatment of patients with cancer, infection, autoimmune diseases and allergies, as well as those patients undergoing organ transplantation or requiring aggressive forms of chemo- or radiotherapy.

In relation to cancer, the identification of novel antigens not only plays a crucial role in the biology and pathology of different types of cancers but also activate both cell-mediated and antibody-mediated immune responses, a more effective immunotherapeutic strategy (i.e. cancer vaccines) for educating our immune system could be developed. In this way, persistent tumour antigens would be recognized and remembered by memory B and T cells already present in the immune system, leading to the prevention of most human cancers (Lollini and Forni, 2003). However, as discussed above, immunization against such persistent tumour antigens should be performed in young people when the immune system is most efficient at recognizing and destroying foreign antigens (Miller, 1996; Abgrall et al., 2002; Davidson et al., 2002; Costello et al., 2003; Lollini and Forni, 2003; Waldman, 2003). Recent advances in this direction may be imminent thanks to advances in tumour immunology, cell and molecular biology of cancer, and mapping of the human genome, together with recent technological advances in genetic engineering and development of monoclonal antibodies (see Chapter 9).

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