Gazit Z, Kedar E
Lautenberg Center for General and Tumor Immunology, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Cancer Immunol Immunother. 1994 Apr;38(4):243-52. doi: 10.1007/BF01533515.
Combinations of chemotherapy and interleukin-2 (IL-2) aimed at improving therapeutic efficacy in cancer patients have generally proved disappointing. Although chemotherapy blocks tumor growth and sometimes boosts immune functions, most drugs are immunosuppressive, at least transiently. Therefore, it is reasonable to assume that maximal exploitation of the immunostimulatory and antitumor activity of both modalities requires careful coordination of chemotherapy and IL-2 timing. We analyzed the temporal effect of 5-fluorouracil (5-FU, 100-120 mg/kg), cyclophosphamide (CY, 100 mg/kg), Adriamycin (8 mg/kg) and dacarbazine (100 mg/kg) on the activation of natural killer/lymphokine-activated killer (NK/LAK) cells by IL-2 in several strains of euthymic mice and in athymic nude mice. Following in vivo or in vitro exposure to IL-2 1-15 days after chemotherapy, the total lytic activity of the spleen and the number of LAK precursors (LAK-p) were measured. In euthymic mice injected with IL-2 (5 x 10(4) Cetus units twice daily for 4-5 days), 5-FU augmented (up to 37-fold, days 1-9) and CY reduced (up to day 6) LAK activity, as compared with that in the IL-2 control. In bulk cultures containing IL-2 (1000 CU/ml, 3-4 days), both 5-FU and CY reduced LAK activity of euthymic mice splenocytes for up to 6 days after chemotherapy, which was followed on day 9 by full recovery. In splenocytes of nude mice, 5-FU increased and CY diminished LAK activation in bulk cultures, starting 3 days after chemotherapy. In athymic mice, 5-FU markedly augmented the total number of LAK-p/spleen (up to 30-fold, days 3-9), as determined by limiting-dilution cultures with IL-2 (for 7-8 days). In euthymic mice, in contrast, LAK-p levels decreased for up to 6-9 days after treatment with 5-FU, Adriamycin or decarbazine, later recovering to pretreatment levels, whereas CY markedly increased LAK-p (up to 15-fold) when administered 6-12 days before limiting-dilution culture initiation. The effect of chemotherapy on LAK and NK activity was essentially similar. In other experiments, a subset of asialoGM1- LAK-p was found in the spleens of 5-FU-treated mice, but not in untreated mice. Our results suggest that the immunomodulatory effect of chemotherapy on NK/LAK activity in mice is variable and largely depends on the drug itself, the interval between chemotherapy and IL-2 administration, the strain of mice and the assay used.
旨在提高癌症患者治疗效果的化疗与白细胞介素-2(IL-2)联合应用,总体上令人失望。尽管化疗可阻断肿瘤生长,有时还能增强免疫功能,但大多数药物具有免疫抑制作用,至少是短暂的。因此,合理的假设是,要最大程度地发挥这两种治疗方式的免疫刺激和抗肿瘤活性,需要仔细协调化疗与IL-2的给药时间。我们分析了5-氟尿嘧啶(5-FU,100 - 120 mg/kg)、环磷酰胺(CY,100 mg/kg)、阿霉素(8 mg/kg)和达卡巴嗪(100 mg/kg)在几种正常胸腺小鼠和无胸腺裸鼠品系中,对IL-2激活自然杀伤/淋巴因子激活的杀伤细胞(NK/LAK)的时间效应。在化疗后1 - 15天进行体内或体外IL-2暴露后,测量脾脏的总溶解活性和LAK前体细胞(LAK-p)的数量。在注射IL-2(5×10⁴ 赛图斯单位,每日两次,共4 - 5天)的正常胸腺小鼠中,与IL-2对照组相比,5-FU增强(第1 - 9天高达37倍)而CY降低(至第6天)LAK活性。在含有IL-2(1000 CU/ml,3 - 4天)的大量培养物中,5-FU和CY均使正常胸腺小鼠脾细胞的LAK活性在化疗后长达6天降低,随后在第9天完全恢复。在裸鼠脾细胞中,5-FU在化疗后3天开始增加,而CY减少大量培养物中的LAK激活。在无胸腺小鼠中,通过用IL-2进行有限稀释培养(7 - 8天)测定,5-FU显著增加了LAK-p/脾脏的总数(第3 - 9天高达30倍)。相比之下,在正常胸腺小鼠中,用5-FU、阿霉素或达卡巴嗪治疗后,LAK-p水平在长达6 - 9天内降低,随后恢复到治疗前水平,而当在有限稀释培养开始前6 - 12天给予CY时,LAK-p显著增加(高达15倍)。化疗对LAK和NK活性的影响基本相似。在其他实验中,在5-FU处理的小鼠脾脏中发现了一部分无唾液酸GM1-LAK-p,但在未处理的小鼠中未发现。我们的结果表明,化疗对小鼠NK/LAK活性的免疫调节作用是可变的,并且在很大程度上取决于药物本身、化疗与IL-2给药之间的间隔、小鼠品系和所使用的检测方法。