Maxwell-Armstrong C A, Durrant L G, Robins R A, Galvin A M, Scholefield J H, Hardcastle J D
University Department of Surgery, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Gut. 1999 Oct;45(4):593-8. doi: 10.1136/gut.45.4.593.
The anti-idiotypic monoclonal antibody 105AD7 mimics the tumour associated antigen 791Tgp72, expressed on 70-80% of colorectal cancers. Phase I studies have shown that the vaccine is non-toxic, and a number of patients have been immunised prior to resection of their primary tumours.
To assess lymphocyte activation at the tumour site by measuring expression of the alpha subunit of the interleukin 2 receptor (CD25).
Nineteen patients with primary colorectal cancer were immunised with varying doses of 105AD7 prior to resection of their primary tumours. Samples of normal bowel and tumour edge/centre from 16 patients were available for immunohistochemical staining with a monoclonal antibody against CD25. Samples from a matched control group were also stained. Fresh tumours from 14 immunised patients and 31 unimmunised control patients were disaggregated, and the lymphocytes obtained labelled for CD25. Samples were analysed blindly by flow cytometry.
Median infiltration of lymphocytes expressing CD25, measured immunohistochemically, was higher in trial patients, as was the ratio of tumour to normal bowel infiltration. Flow cytometric analysis of fresh tumour from immunised patients showed a significantly higher percentage of lymphocytes expressing CD25 tumour infiltrating lymphocytes than their matched and unmatched controls.
The alpha subunit of the interleukin 2 receptor is increased on tumour infiltrating lymphocytes, in patients immunised with the colorectal cancer vaccine 105AD7. This suggests a population of activated lymphocytes capable of targeting 791Tgp72 expressing tumour cells, such as circulating micrometastases. 105AD7 may have a role as adjuvant therapy in early stage disease.
抗独特型单克隆抗体105AD7可模拟肿瘤相关抗原791Tgp72,该抗原在70%-80%的结直肠癌中表达。I期研究表明,该疫苗无毒,且一些患者在原发性肿瘤切除前已接种疫苗。
通过检测白细胞介素2受体α亚基(CD25)的表达来评估肿瘤部位的淋巴细胞激活情况。
19例原发性结直肠癌患者在原发性肿瘤切除前接受了不同剂量的105AD7免疫接种。16例患者的正常肠组织和肿瘤边缘/中心样本可用于用抗CD25单克隆抗体进行免疫组织化学染色。来自匹配对照组的样本也进行了染色。对14例免疫接种患者和31例未免疫接种对照患者的新鲜肿瘤进行解离,并对获得的淋巴细胞进行CD25标记。样本通过流式细胞术进行盲法分析。
通过免疫组织化学测量,表达CD25的淋巴细胞的中位浸润在试验患者中更高,肿瘤与正常肠组织浸润的比例也是如此。对免疫接种患者的新鲜肿瘤进行流式细胞术分析显示,表达CD25的肿瘤浸润淋巴细胞的百分比显著高于其匹配和不匹配的对照组。
在用结直肠癌疫苗105AD7免疫接种的患者中,肿瘤浸润淋巴细胞上白细胞介素2受体α亚基增加。这表明存在一群能够靶向表达791Tgp72的肿瘤细胞(如循环微转移灶)的活化淋巴细胞。105AD7可能在早期疾病中作为辅助治疗发挥作用。