Mandressi A
Istituto di Urologia, Università degli Studi di Milano.
Arch Ital Urol Nefrol Androl. 1991 Jun;63(2):229-32.
IL-2 is a lymphokine which as variety of in vivo immunomodulatory effects. The administration of IL-2 can mediate enhancement of cellular immune response, induction of lymphocyte proliferation and production of cytokines. The availability of large quantities of recombinant IL-2 has enabled investigator to examine its therapeutic potential, with of without lymphokine-activated killer cell, in the treatment of metastatic renal cancer. Several studies have documented the ability of IL-2 administration to cause durable tumor regression in a good percentage of patients. Otherwise there were a number of problems which had to be resolved. First, the high-dose bolus or low-dose continuous infusion? Indeed, administration by the intravenous or subcutaneous routes? Last but non least, what is the place of lymphokine-activated Killer cells? Toxicity of therapy is dose related and is mediated by a vascular capillary leak syndrome, lymphocytic infiltration and the release of cytokines secreted in response to IL-2 administration. The side effects are completely reversible upon cessation of therapy. The patients undoubtedly require much more careful monitoring than with standard oncological treatments but rapid recovery of the preexisting conditions before therapy suspension must certainly be stressed.
白细胞介素-2是一种具有多种体内免疫调节作用的淋巴因子。给予白细胞介素-2可介导细胞免疫反应增强、淋巴细胞增殖诱导以及细胞因子产生。大量重组白细胞介素-2的可获得性使研究人员能够研究其在治疗转移性肾癌中(无论有无淋巴因子激活的杀伤细胞)的治疗潜力。多项研究记录了给予白细胞介素-2能使相当比例的患者实现持久的肿瘤消退。否则存在一些必须解决的问题。首先,是大剂量推注还是小剂量持续输注?确实,是通过静脉内还是皮下途径给药?最后但同样重要的是,淋巴因子激活的杀伤细胞的地位如何?治疗毒性与剂量相关,由血管毛细血管渗漏综合征、淋巴细胞浸润以及因给予白细胞介素-2而分泌的细胞因子释放介导。停止治疗后副作用完全可逆。与标准肿瘤治疗相比,这些患者无疑需要更仔细的监测,但必须强调在治疗暂停前原有状况能迅速恢复。