Vita Francesca, Siracusano Salvatore, Abbate Rita, Ciciliato Stefano, Borelli Violetta, Soranzo Maria Rosa, Zabucchi Giuliano
Department of Physiology, University of Trieste, Italy.
Can J Urol. 2011 Feb;18(1):5517-23.
Bacillus Calmette-Guerin (BCG) is used to treat high risk superficial bladder cancer, but its anti-tumor effect remains incompletely defined. Recently a role for polymophonuclear (PMN) neutrophils has been suggested. To investigate the role of granulocytes, we monitored the activation state of these cells in the urine of BCG-treated patients.
Ten patients with stage T1, grade 3 (T1G3) transitional cell carcinoma received an 8 week course of BCG after undergoing transurethral resection of the bladder. Cytological and enzymatic analyses of urine samples collected before and 2 hours after the physiological expulsion of BCG were performed. The activation state of urine granulocytes and the presence of activating factors within the urine samples were monitored.
BCG immunotherapy stimulated, through soluble factors, the activation of PMN neutrophils, which transmigrated into the bladder, and the degree of activation of the PMN neutrophils was related directly to the number of epithelial cells detached from the urothelial layer.
This study suggests that PMN neutrophils can participate in reducing the recurrence of bladder cancer by promoting urothelial cell turnover proportionally to their degree of activation. Our results provide further evidence to support the role of PMN neutrophils in BCG immunotherapy.
卡介苗（BCG）用于治疗高危浅表性膀胱癌，但其抗肿瘤作用仍未完全明确。最近有研究表明多形核（PMN）中性粒细胞发挥了作用。为了研究粒细胞的作用，我们监测了卡介苗治疗患者尿液中这些细胞的激活状态。
10例T1期3级（T1G3）移行细胞癌患者在接受经尿道膀胱切除术后接受了为期8周的卡介苗治疗。对卡介苗自然排出前和排出后2小时收集的尿液样本进行细胞学和酶学分析。监测尿液粒细胞的激活状态以及尿液样本中激活因子的存在情况。
卡介苗免疫疗法通过可溶性因子刺激PMN中性粒细胞的激活，这些中性粒细胞迁移至膀胱，并且PMN中性粒细胞的激活程度与从尿路上皮层脱落的上皮细胞数量直接相关。
本研究表明，PMN中性粒细胞可通过按其激活程度促进尿路上皮细胞更新来参与降低膀胱癌的复发率。我们的结果为支持PMN中性粒细胞在卡介苗免疫疗法中的作用提供了进一步的证据。
