Neutrophils in cancer and sepsis: shared mechanisms of immune dysregulation

Neutrophils, the predominant leukocytes of the innate immune system, are increasingly recognized as potential participants in processes that either promote or suppress tumor development, depending on the tumor's biological characteristics.
Purpose of the study. This narrative review aims to analyze and summarize current knowledge on the functional plasticity and heterogeneity of neutrophils, as well as their dual role in the pathogenesis of cancer and sepsis. Particular attention is given to shared mechanisms of neutrophil dysregulation in these conditions and to the prospects for developing targeted therapeutic strategies.
Materials and methods. A selective literature search was conducted in the PubMed, eLibrary.ru, and Scopus databases covering the past 15 years using the following keywords: “neutrophils”, “cancer”, “sepsis”, “neutrophils in cancer and sepsis”, “immune dysregulation in cancer and sepsis”, “neutrophil plasticity in tumor and infection”, “immunotherapy and sepsis in cancer patients”, “oxidative stress in neutrophils”, “neutrophil–lymphocyte ratio”, and “sepsis-induced tumor growth”. Publications were selected based on their scientific significance, relevance to the topic, and compliance with contemporary evidence-based medicine standards.
Results. The analysis revealed the dual role of neutrophils in cancer and their complex interactions within the tumor microenvironment. The review discusses two neutrophil subtypes, N1 and N2, which exert opposing effects on tumor biology. It also examines the role of neutrophils in the formation and function of neutrophil extracellular traps (NETs), which contribute to cancer progression through their involvement in inflammation, angiogenesis, and metastasis. In addition, the review highlights shared mechanisms of neutrophil involvement in cancer progression and sepsis in oncology patients, with particular emphasis on activated neutrophils and NET formation.
Conclusion. Integrating current knowledge on neutrophil involvement in cancer progression and sepsis in oncology patients may guide future research toward the development of more precise and effective therapeutic strategies for cancer complicated by sepsis, ultimately improving patient outcomes.

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