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Clinical and Developmental Immunology
Volume 2012, Article ID 293479, 4 pages
Review Article

The Role of Regulatory T Cells and TH17 Cells in Multiple Myeloma

1Disciplina de Hematologia e Hemoterapia, Departamento de Oncologia Clínica e Experimental, Campus São Paulo, UNIFESP, Rua Botucatu 740, 3o Andar, 04023-900 São Paulo, SP, Brazil
2Department of Oncology and Hematology and Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

Received 6 December 2011; Accepted 12 February 2012

Academic Editor: Nicolaus Kröger

Copyright © 2012 Walter M. T. Braga et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The development of multiple myeloma (MM) involves a series of genetic alterations and changes in the bone marrow microenvironment, favoring the growth of the tumor and failure of local immune control. Quantitative and functional alterations in CD4+ and CD8+ T cells have been described in MM. The balance between T regulatory cells (Treg) and T helper (Th) 17 cells represents one essential prerequisite for maintaining anti-tumor immunity in MM. Tregs play an important role in the preservation of self-tolerance and modulation of overall immune responses against infections and tumor cells. In MM patients, Tregs seem to contribute to myeloma-related immune dysfunction and targeting them could, therefore, help to restore and enhance vital immune responses. Th17 cells protect against fungal and parasitic infections and participate in inflammatory reactions and autoimmunity. The interplay of TGF-β and IL-6, expressed at high levels in the bone marrow of myeloma patients, may affect generation of Th17 cells both directly or via other pro-inflammatory cytokines and thereby modulate antitumor immune responses. A detailed analysis of the balance between Tregs and Th17 cells seems necessary in order to design more effective and less toxic modes of immunotherapy myeloma which still is an uncurable malignancy.