Herrlinger U, Buchholz R, Jachimczak P, Schabet M
Department of Neurology, University of Tuebingen, Germany.
J Neurooncol. 1996 Mar;27(3):193-203. doi: 10.1007/BF00165475.
The efficacy of intrathecal treatment of leptomeningeal metastasis (LM) with interleukin-2 (IL-2) was evaluated in an animal model using Wistar rats inoculated intracisternally with 10(7) C6 glioma cells. Prior to the in vivo experiments the antiproliferative effects of human IL-2, and of murine IFN-gamma and TNF-alpha which are cytokines induced by IL-2 were tested in a colony forming assay. Only IFN-gamma caused a dose-dependent inhibition of colony formation. Twelve animals were treated intracisternally with either 10(5) IU IL-2 or control medium on day 0, 2, and 5 after tumor cell inoculation. Both IL-2 treated and sham-treated animals developed LM with a symptom-free survival of 7 to 9 days. There was no significant difference between treated and untreated animals regarding time to onset of symptoms and pattern of tumor growth. Infiltration of the tumor tissue with ED-1+ monocytes and macrophages, and CD8+ lymphocytes, however, was slightly increased in IL-2 treated animals. In a second experiment 4 non tumor-bearing Wistar rats were intracisternally injected with a single dose of 10(5) IU IL-2. These animals also showed slightly enhanced leptomeningeal infiltration with CD8+ lymphocytes compared to controls. We conclude that intrathecal application of high-dose IL-2 although eliciting a slight immune reaction within the leptomeninges does not inhibit leptomeningeal tumor growth or prolong symptom-free survival in our animal model of LM. These results raise doubt about the clinical efficacy of intrathecal IL-2 treatment in patients with LM.
在一个动物模型中,利用向脑池内接种10⁷个C6胶质瘤细胞的Wistar大鼠,评估了鞘内注射白细胞介素-2(IL-2)治疗柔脑膜转移(LM)的疗效。在体内实验之前,在集落形成试验中测试了人IL-2以及由IL-2诱导的细胞因子鼠干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)的抗增殖作用。只有IFN-γ引起了集落形成的剂量依赖性抑制。在肿瘤细胞接种后的第0、2和5天,对12只动物进行脑池内注射10⁵国际单位(IU)的IL-2或对照培养基。接受IL-2治疗和假治疗的动物均发生了LM,无症状生存期为7至9天。在症状出现时间和肿瘤生长模式方面,治疗组和未治疗组动物之间没有显著差异。然而,在接受IL-2治疗的动物中,肿瘤组织中ED-1⁺单核细胞、巨噬细胞和CD8⁺淋巴细胞的浸润略有增加。在第二个实验中,对4只未荷瘤的Wistar大鼠脑池内注射单剂量10⁵IU的IL-2。与对照组相比,这些动物的柔脑膜中CD8⁺淋巴细胞浸润也略有增强。我们得出结论,在我们的LM动物模型中,鞘内应用高剂量IL-2虽然在柔脑膜内引发了轻微的免疫反应,但并不能抑制柔脑膜肿瘤生长或延长无症状生存期。这些结果对鞘内注射IL-2治疗LM患者的临床疗效提出了质疑。