Miyazaki Jun, Onozawa Mizuki, Takaoka Eiichiro, Yano Ikuya
Department of Urology, School of Medicine, International University of Health and Welfare, Chiba, Japan.
Faculty of Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Int J Urol. 2018 May;25(5):405-413. doi: 10.1111/iju.13538. Epub 2018 Mar 5.
In the past 40 years, intravesical immunotherapy with Mycobacterium bovis bacillus Calmette-Guérin has been carried out as the most effective treatment for preventing local recurrences and tumor progression of non-muscle-invasive bladder cancer. Bacillus Calmette-Guérin is a family of vaccines derived in 1921 by the in vitro attenuation of Mycobacterium bovis. Subsequently, bacillus Calmette-Guérin seed lots were spread around the world, and both phenotypic and genotypic differences among the strains have been compiled. In recent genomic comparisons, the evolution of the different bacillus Calmette-Guérin substrains has begun to emerge. However, some of these genetic alterations in bacillus Calmette-Guérin strains have yet to be shown to affect the therapeutic effects and/or adverse effects. There are thus ongoing research efforts to assess the effects of these genetic alterations on the properties of bacillus Calmette-Guérin strains, with the ultimate goal of identifying an ideal bacillus Calmette-Guérin strain for treatment of non-muscle-invasive bladder cancer and providing clues for the improvement of bacillus Calmette-Guérin strains. The present review provides a history of bacillus Calmette-Guérin immunotherapy, and discusses the genetic differences among bacillus Calmette-Guérin strains, the different clinical outcomes afforded by bacillus Calmette-Guérin strains and possible future developments.
在过去40年里，卡介苗膀胱内免疫疗法一直作为预防非肌层浸润性膀胱癌局部复发和肿瘤进展的最有效治疗方法。卡介苗是1921年通过牛分枝杆菌的体外减毒而衍生出的一类疫苗。随后，卡介苗种子批传播到世界各地，并且已经汇总了各菌株之间的表型和基因型差异。在最近的基因组比较中，不同卡介苗亚菌株的进化情况已开始显现。然而，卡介苗菌株中的一些基因改变尚未被证明会影响治疗效果和/或不良反应。因此，目前正在进行研究，以评估这些基因改变对卡介苗菌株特性的影响，最终目标是确定用于治疗非肌层浸润性膀胱癌的理想卡介苗菌株，并为改进卡介苗菌株提供线索。本综述介绍了卡介苗免疫疗法的历史，并讨论了卡介苗菌株之间的基因差异、卡介苗菌株带来的不同临床结果以及未来可能的发展。
