Radiofrequency ablation (RFA) is a mini-invasive loco-regional ablation technique that is increasingly being used as a palliative treatment for pancreatic cancer and cholangiocarcinoma. Ablation-triggered immune system stimulation has been proposed as a mechanism behind the systemic effects of RFA. The aim of our study was to investigate the immune response to endoluminal biliary RFA. Peripheral blood samples were collected from patients with pancreatic cancer and cholangiocarcinoma randomised to receive endoluminal biliary radiofrequency ablation + stent (19 patients) or stent only (21 patients). We observed an early increase in IL-6 levels and a delayed increase in CXCL1, CXCL5, and CXCL11 levels as well as an increase in CD8+ and NK cells. However, these changes were not specific to RFA treatment. Explicitly in response to RFA, we observed a delayed increase in serum CXCL1 levels and an early decrease in the number of anti-inflammatory CD206+ blood monocytes. Our study provides the first evidence of endoluminal biliary RFA-based regulation of the systemic immune response in patients with pancreatic cancer and cholangiocarcinoma. These changes were characterised by a general inflammatory response. RFA-specific activation of the adaptive immune system was not confirmed.

Department of Clinical and Transplant Immunology Institute for Clinical and Experimental Medicine Videnska 1958 140 21 Prague Czech Republic

Department of Data Analysis Statistics and Artificial Intelligence Institute for Clinical and Experimental Medicine Videnska 1958 140 21 Prague Czech Republic

Department of Gastroenterology and Hepatology Institute for Clinical and Experimental Medicine Videnska 1958 140 21 Prague Czech Republic

Department of Internal Medicine 2 Gastroenterology and Hepatology University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc 1 P Pavlova 185 6 779 00 Olomouc Czech Republic

Department of Internal Medicine 3rd Faculty of Medicine Charles University University Hospital Kralovske Vinohrady Srobarova 1150 100 34 Prague Czech Republic

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