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Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after bacillus Calmette-Guérin treatment.
- Source :
-
BJU international [BJU Int] 2001 Oct; Vol. 88 (6), pp. 602-10. - Publication Year :
- 2001
-
Abstract
- Objective: To compare the immunological status of normal and peritumoral bladder walls, and to characterize immunocompetent cells before and during intravesical instillations of bacillus Calmette-Guérin (BCG).<br />Patients and Methods: Twenty-three patients with superficial urothelial bladder carcinoma (stages pTa to pT1, grades 1-3) were treated with six weekly instillations of 150 mg of BCG (Pasteur strain). Biopsies of cystoscopically normal bladder wall were taken before, 3 weeks and 3 months after BCG instillation. The controls comprised bladder biopsy specimens from 13 brain-dead ventilated kidney donors. Local infiltrating cell types, i.e. lymphocyte infiltrates (CD4, CD8, CD20, CD3, interleukin-2-receptor-positive, natural killer, gammadelta), macrophages and dendritic cells, adhesion and costimulatory molecules (ICAM-1 and B7-BB1) and major histocompatibility complex (MHC) class I and class II antigens were assessed using semi-quantitative immunohistochemical analysis.<br />Results: Before BCG the peritumoral bladder wall had fewer macrophages than control bladder wall. BCG treatment restored normal numbers of macrophages and enhanced T helper lymphocytes, B lymphocytes, natural killer cells, activated lymphocytes, dendritic cells, normal MHC class I, adhesion (ICAM-1) and costimulatory (B7-BB1) expression. The enhancement of these immunological variables was transient, with a return to baseline 3 months after BCG instillation.<br />Conclusions: These results support the concept that there is a host-immune escape associated with bladder cancer. BCG therapy may temporarily restore impaired tumour rejection mechanisms in the peritumoral bladder wall, suggesting a need for maintenance therapy after the first course of BCG.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibody Specificity
Biopsy
Female
Humans
Immunity, Cellular
Immunocompromised Host
Immunohistochemistry
Lymphocyte Subsets immunology
Male
Middle Aged
Neoplasm Staging
T-Lymphocytes, Helper-Inducer immunology
T-Lymphocytes, Regulatory immunology
Urinary Bladder Neoplasms therapy
Mycobacterium bovis immunology
Urinary Bladder immunology
Urinary Bladder Neoplasms immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1464-4096
- Volume :
- 88
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- BJU international
- Publication Type :
- Academic Journal
- Accession number :
- 11678759
- Full Text :
- https://doi.org/10.1046/j.1464-410x.2001.02394.x