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Cancer attacks immune cells A balance between cancer and anti-metastasis defense in the metastasis-target organs is a key factor in the process of metastasis formation. HMGB1 is a bifunctional protein; a chromatin component regulating transcriptional gene expression and DNA repair, and an inflammatory cytokine worsening endotoxic shock. HMGB1 is released from nuclei under chromatin histone acetylation or cell necrosis. In cancer cells, HMGB1 activates its receptor, RAGE (receptor for advanced glycation end products), which is a multifunctional membrane protein, to accelerate proliferation, motility, invasion, angiogenesis, and metastasis. In macrophages and dendritic cells, HMGB1 induces apoptosis at high concentration via JNK phosphorylation. HMGB1-induced apoptosis inhibits macrophage infiltration into the tumors. HMGB1 also affects resident macrophages in the lymph nodes and liver. HMGB1 secreted from colon cancer cells in the primary tumors reaches the metastasis-target organs via portal or lymphatic flow, and suppresses the resident macrophages to reduce resistance on cancer cell embedding. The effect of cancer-derived cytokines on the metastasis-target organs might be a pivotal scenario in cancer metastasis. Kuniyasu H, Oue N, Wakikawa A, Shigeishi H, Matsutani N, Kuraoka K, Ito R, Yokozaki H, Yasui W: Expression of receptors for advanced glycation end products (RAGE) is closely associated with invasive and metastatic activity of gastric cancer. J Pathol 196(2):163-170, 2002 Kuniyasu H, Chihara Y, Kondo H: Differential effects between amphoterin and advanced glycation end products on colon cancer cells. Int J Cancer 104(6): 722-727, 2003 Kuniyasu H, Chihara Y, Takahashi T : Co-expression of receptor for advanced glycation end products and the ligand amphoterin associates closely with metastasis of colorectal cancer. Oncology Reports 10(2): 445-448, 2003 Kuniyasu H, Chihara Y, Kondo H, Ohmori H, Ukai R: Amphoterin induction in prostatic stromal cells by androgen deprivation is associated with metastatic prostate cancer. Oncology Reports 10(6): 1863-1868, 2003. Kuniyasu H, Sasahira T, Sasaki T, Ohmori H and Takahashi T: Depletion of infiltrating macrophages is associated with amphoterin expression in colon cancer. Pathobiol 71:129-136, 2004. Kuniyasu H, Yano S, Sasaki T, Sasahira T, Sone S, Ohmori H: Colon cancer cell derived-HMGB1/ amphoterin induces growth inhibition and apoptosis in macrophages. Am J Pathol 166(3): 751-759, 2005. Sasahira T, Akama Y, Fujii K, Kuniyasu H: Expression of receptor for advanced glycation end products (RAGE) and HMGB1/amphoterin in colorectal adenomas. Virchows Archiv 446(4): 411-415, 2005. Sasahira T, Sasaki T, Kuniyasu H : Interleukin-15 and transforming growth factor α are associated with depletion of tumor-associated macrophages in colon cancer. J Exp Clin Cancer Res 24(1): 69-74, 2005. Bhawal UK, Ozaki Y, Nishimura M, Sugiyama M, Sasahira T, Nomura Y, Sato F, Fujimoto K, Sasaki N, Ikeda MA, Tsuji K, Kuniyasu H, Kato Y : Association of expression of receptors for advanced glycation end-products (RAGE) and invasive and metastatic activity of oral squamous cell carcinoma. Oncology 69(3): 246-255, 2005. Sasahira T, Kirita T, Bhawal UK, Ikeda M, Nagasawa A, Yamamoto K, Kuniyasu H: The expression of receptor for advanced glycation end products is associated with angiogenesis in human oral squamous cell carcinoma. Virchows Archiv 450(3):287-295, 2007. Sasahira T, Kirita T, Bhawal UK, Yamamoto K, Kuniyasu H: Receptor for advanced glycation end products (RAGE) is important in the prediction of recurrence in human oral squamous cell carcinoma. Histopathol 51(2): 166-172, 2007. Fujii K, Luo Y, Sasahira T, Denda A, Ohmori H, Kuniyasu H: Co-treatment with deoxycholic acid and azoxymethane accelerates the secretion of HMGB1 in IEC6 intestinal epithelial cells Cell Prolif, in press. Kusume A, Sasahira T, Luo Y, Isobe M, Nakagawa N, Tatsumoto N, Fujii K, Ohmori H, Kuniyasu H: Suppression of dendritic cells by HMGB1 is associated with lymph node metastasis of human colon cancer. Pathobiol, in press.