Heaton K M, Ju G, Grimm E A
Department of Tumor Biology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Ann Surg Oncol. 1994 May;1(3):198-203. doi: 10.1007/BF02303524.
Interleukin-2 (IL-2)-based immunotherapy has been shown to effect clinical responses in 15-35% of patients with metastatic renal cell carcinoma or melanoma. Despite its clinical efficacy, many clinicians refrain from using IL-2 because of the associated toxicity. This toxicity is believed to be mediated by such secondary cytokines as IL-1, tumor necrosis factor (TNF), and interferon (IFN)-gamma, which are produced by the patient's IL-2-stimulated peripheral blood mononuclear cells (PBMCs).
Human PBMCs were stimulated with 1 nM wild-type recombinant IL-2 (rIL-2) or IL-2 analogs (R38A or F42K) that preferentially bind to the intermediate affinity IL-2 receptor (IL-2R). PBMCs were activated for lymphokine-activated killer (LAK) activity in 4-h 51Cr-release assays, using Daudi target cells. Cytokine content in the culture supernatants was determined by enzyme-linked immunosorbent assay.
Both R38A and F42K were capable of generating substantial LAK activity. Maximal specific lysis was 54% for PBMCs activated by R38A and 52% for F42K-stimulated cells, in contrast to 64% for rIL-2. In addition, analog-stimulated PBMCs secreted 59% of the IL-1 beta, 25% of the TNF-alpha, and only 8% of the IFN-gamma produced in response to rIL-2 (all p < 0.01 compared with rIL-2-stimulated secretion; one-way ANOVA).
IL-2 analogs that preferentially bind the intermediate-affinity IL-2R retain the capacity to induce substantial LAK activity despite a greatly reduced secondary cytokine production. Therefore, such IL-2 analogs may provide an effective, yet less toxic means of cancer immunotherapy.
基于白细胞介素-2(IL-2)的免疫疗法已被证明可使15%至35%的转移性肾细胞癌或黑色素瘤患者产生临床反应。尽管其具有临床疗效,但由于相关毒性,许多临床医生仍避免使用IL-2。据信这种毒性是由患者IL-2刺激的外周血单个核细胞(PBMC)产生的诸如IL-1、肿瘤坏死因子(TNF)和干扰素(IFN)-γ等二级细胞因子介导的。
用人PBMC与优先结合中等亲和力IL-2受体(IL-2R)的1 nM野生型重组IL-2(rIL-2)或IL-2类似物(R38A或F42K)进行刺激。在使用Daudi靶细胞的4小时51Cr释放试验中,激活PBMC以产生淋巴因子激活的杀伤细胞(LAK)活性。通过酶联免疫吸附测定法测定培养上清液中的细胞因子含量。
R38A和F42K均能够产生大量LAK活性。R38A激活的PBMC的最大特异性裂解率为54%,F42K刺激的细胞为52%,而rIL-2激活的细胞为64%。此外,类似物刺激的PBMC分泌的IL-1β为rIL-2刺激后分泌量的59%,TNF-α为25%,IFN-γ仅为8%(与rIL-2刺激后的分泌相比,所有p<0.01;单因素方差分析)。
优先结合中等亲和力IL-2R的IL-2类似物尽管二级细胞因子产生量大幅减少,但仍保留诱导大量LAK活性的能力。因此,此类IL-2类似物可能提供一种有效但毒性较小的癌症免疫治疗手段。