Kim C I, Shin J S, Kim H I, Lee J M, Kim S J
Department of Urology, Kyemyung University College of Medicine, Taegu, Korea.
Yonsei Med J. 1993 Dec;34(4):356-64. doi: 10.3349/ymj.1993.34.4.356.
Although an immune response to bacillus Calmette Guérin (BCG) has often been associated with antitumor activity, the action mechanism(s) of intravesical BCG therapy for prophylaxis and treatment of superficial bladder cancer is not clearly understood. In an attempt to evaluate the roles of tumor necrosis factor (TNF)-alpha and lymphotoxin (LT) in the antitumor activity, TNF-alpha productivities by peripheral blood monocytes, serum levels of TNF-alpha, and LT productivities by peripheral blood lymphocytes were studied in superficial bladder cancer patients after six intravesical administrations of BCG. TNF-alpha productivities by peritoneal macrophages of guinea pigs were also studied after six intravesical administrations of BCG. The maximum TNF-alpha productivities by peripheral blood monocytes of superficial bladder cancer patients were seen after the fourth week of administration of BCG, and the serum TNF-alpha levels were also slightly increased after intravesical BCG administration in the superficial bladder cancer patients. LT productivities by peripheral blood lymphocytes of superficial bladder cancer patients were significantly enhanced and the maximum LT productivity was also seen after the third or fifth BCG administration. TNF-alpha productivities by peritoneal macrophages of guinea pigs were significantly enhanced and the maximum TNF-alpha productivity was seen after the second or third BCG administration. Our data might suggest that six consecutive intravesical BCG administrations could induce the increased productions of TNF-alpha and LT, which might play an important role in the antitumor activity in superficial bladder cancer.
尽管对卡介苗（BCG）的免疫反应常与抗肿瘤活性相关，但膀胱内灌注BCG预防和治疗浅表性膀胱癌的作用机制尚不清楚。为了评估肿瘤坏死因子（TNF）-α和淋巴毒素（LT）在抗肿瘤活性中的作用，我们研究了浅表性膀胱癌患者在膀胱内灌注6次BCG后外周血单核细胞的TNF-α产生能力、血清TNF-α水平以及外周血淋巴细胞的LT产生能力。我们还研究了豚鼠在膀胱内灌注6次BCG后腹腔巨噬细胞的TNF-α产生能力。浅表性膀胱癌患者外周血单核细胞的最大TNF-α产生能力在灌注BCG后第4周出现，浅表性膀胱癌患者膀胱内灌注BCG后血清TNF-α水平也略有升高。浅表性膀胱癌患者外周血淋巴细胞的LT产生能力显著增强，最大LT产生能力在第3次或第5次灌注BCG后出现。豚鼠腹腔巨噬细胞的TNF-α产生能力显著增强，最大TNF-α产生能力在第2次或第3次灌注BCG后出现。我们的数据可能表明，连续6次膀胱内灌注BCG可诱导TNF-α和LT产生增加，这可能在浅表性膀胱癌的抗肿瘤活性中发挥重要作用。
