Open AccessChanges in urinary cytokines and soluble intercellular adhesion molecule‐1 (ICAM‐1) in bladder cancer patients after Bacillus Calmette—Guérin (BCG) immunotherapy
Author(s) -
JACKSON A. M.,
ALEXANDROFF A. B.,
KELLY R. W.,
SKIBINSKA A.,
ESUVARANATHAN K.,
PRESCOTT S.,
CHISHOLM G. D.,
JAMES K.
Publication year - 1995
Publication title -
clinical & experimental immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 135
eISSN - 1365-2249
pISSN - 0009-9104
DOI - 10.1111/j.1365-2249.1995.tb05560.x
Subject(s) - immunotherapy , intercellular adhesion molecule 1 , bladder cancer , urinary system , immunology , icam 1 , medicine , cancer , urinary bladder , adhesion , cell adhesion molecule , intracellular , cancer immunotherapy , cancer research , immune system , biology , chemistry , biochemistry , organic chemistry
SUMMARY Intravesical immunotherapy for carcinoma in situ of the bladder is arguably the most effective form of tumour immunotherapy described to date. Following repeated instillations of BCG organisms into the bladder, large quantities of cytokines are detected in patients’ urine. This study concerns the production of IL‐1β, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10, tumour necrosis factor‐alpha (TNF‐α), interferon‐gamma (IFN‐γ) and soluble ICAM‐1 (sICAM‐1) throughout the six weekly instillations which comprise a therapeutic course. Sequential instillations of BCG induced secretion of IL‐1β, IL‐2, IL‐6, IL‐8, IL‐10, TNF‐α, IFN‐γ and sICAM‐1 into urine. The responses were heterogeneous between patients and cytokines, but some general trends were evident. Although cytokine levels were initially low, their concentration increased with repeated instillation of BCG. Certain cytokines (e.g. IL‐6, IL‐8 and IL‐10) could be detected after the first instillation, whilst others (e.g. IL‐2 and IFN‐γ) were not detected until after the third or fourth instillation. Interestingly, IL‐4 was not detected, perhaps suggesting a differential effect on Th2‐like responses. Some patients produced particularly elevated or non‐detectable levels of cytokines, and a positive correlation was found between the production of various cytokines. The production of a particular cytokine did not correspond with lack of production of another species. Whether monitoring the production of cytokines following therapy may be of prognostic value will be determined in a larger series of patients. However, as these potent immunomodulators are thought t o be important for the 75% complete clinical response observed with BCG therapy, there remains the possibility that detection of the products of an activated immune system may correlate with eventual clinical outcome. This study is a necessary forerunner to full prognostic evaluation of such immunological data.