Sathish S, Srivastava S, Khan T. Relationship between inflammation, depression, and immune surveillance in oral cancer. World J Clin Cases 2026; 14(19): 122106 [DOI: 10.12998/wjcc.v14.i19.122106]
Corresponding Author of This Article
Sivan Sathish, Head, Professor, Department of Oral Medicine and Radiology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Delhi Road, Moradabad 244001, Uttar Pradesh, India. drsivan.dental@tmu.ac.in
Research Domain of This Article
Psychiatry
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review-article
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Sathish S, Srivastava S, Khan T. Relationship between inflammation, depression, and immune surveillance in oral cancer. World J Clin Cases 2026; 14(19): 122106 [DOI: 10.12998/wjcc.v14.i19.122106]
Relationship between inflammation, depression, and immune surveillance in oral cancer
Tabiha Khan, Shilpi Srivastava, Sivan Sathish
Sivan Sathish, Shilpi Srivastava, Tabiha Khan, Department of Oral Medicine and Radiology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad 244001, Uttar Pradesh, India
Author contributions: Sathish S conceptualized and designed the review, developed the overall framework, conducted the literature search, coordinated and performed manuscript writing, and prepared the figures and tables; Srivastava S contributed to literature evaluation and assisted in manuscript drafting; Khan T contributed to clinical interpretation and provided critical clinical insights for the manuscript.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Corresponding author: Sivan Sathish, Head, Professor, Department of Oral Medicine and Radiology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Delhi Road, Moradabad 244001, Uttar Pradesh, India. drsivan.dental@tmu.ac.in
Received: April 10, 2026 Revised: May 6, 2026 Accepted: May 21, 2026 Published online: July 6, 2026 Processing time: 84 Days and 0.3 Hours
Abstract
Oral cancer is characterized by complex interactions between tumor biology, host immune surveillance, and systemic inflammatory processes. Increasing evidence indicates that depressive symptoms in patients with oral cancer are associated with persistent inflammatory activation and immune dysregulation, extending beyond psychosocial morbidity to biologically relevant alterations in antitumor defense. Depression is linked to elevated circulating pro-inflammatory mediators, including interleukin-6, tumor necrosis factor-α, and C-reactive protein, alongside neuroendocrine imbalance that influences immune cell trafficking and function. In oral cancer, this inflammatory milieu coincides with impaired innate and adaptive immune mechanisms critical for tumor surveillance, including reduced natural killer cell cytotoxicity, altered T-lymphocyte subsets, diminished antigen presentation capacity, and increased expression of immune exhaustion markers. Chronic inflammation associated with depressive symptoms may further exacerbate tumor-promoting processes, such as angiogenesis, epithelial-mesenchymal transition, and immune evasion within the oral tumor microenvironment. The convergence of inflammation, depression, and immune surveillance constitutes a biologically significant axis in oral cancer, potentially shaping disease progression, treatment response, and clinical outcomes.
Core Tip: Inflammation, depression, and immune surveillance constitute a biologically integrated axis in oral cancer. Chronic inflammatory activation and depression-associated neuroendocrine dysregulation impair antitumor immune responses, leading to reduced immune surveillance, tumor progression, and immune evasion. Recognition of this integrated axis provides a mechanistic framework for disease progression and supports the development of improved prognostic models and integrative therapeutic strategies.
