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Influence of intravesical bacillus Calmette-Guérin therapy on systemic immunological status
1Department of Urology, Toyooka Hospital, Japan.
Insights
Intravesical bacillus Calmette-Guérin (BCG) therapy for bladder cancer alters systemic immunity. Good responders showed distinct immune cell changes compared to poor responders, indicating therapy
Area of Science:
- Immunology
- Oncology
- Urology
Background:
- Intravesical bacillus Calmette-Guérin (BCG) therapy is a standard treatment for superficial bladder cancer.
- BCG instillation is known to elicit local immune responses within the bladder.
Purpose of the Study:
- To investigate the systemic immunological effects of intravesical BCG therapy.
- To compare systemic immune changes between good and poor responders to BCG treatment.
Main Methods:
- Peripheral blood lymphocyte subsets (PBLS) and monocyte counts were analyzed using two-colored flow cytometry.
- 30 patients with superficial bladder carcinoma were monitored before, during, and after BCG treatment.
- Patients were categorized into good (24) and poor (6) responders.
Main Results:
- A significant alteration in PBLS and monocyte counts was observed between 3 and 12 months post-treatment, characterized by increased suppressor T cells and decreased helper T cells.
- Good responders exhibited higher counts of natural killer cells, cytotoxic T cells, and inducer T cells compared to poor responders, particularly at 1 month.
- These differential immune cell count differences between responders diminished by 3 months after treatment initiation.
Conclusions:
- Intravesical BCG therapy induces significant and lasting changes in the systemic immune status.
- The observed systemic immune alterations may correlate with treatment efficacy in superficial bladder cancer.
Background:
Intravesical bacillus Calmette-Guérin (BCG) therapy for superficial bladder cancer induces obvious local immunological responses. The purpose of this study was to examine the systemic immunological influences induced by intravesical BCG therapy.
Methods:
We measured peripheral blood lymphocyte subsets (PBLS) and monocyte counts in 30 patients with superficial bladder carcinoma by two-colored flow cytometry before, during, and after intravesical BCG treatment. Comparisons were made between 24 good treatment responders and 6 poor responders.
Results:
From 3 to 12 months after the beginning of treatment, PBLS and monocyte counts changed, as evidenced by an increase of suppressor T cells and a decrease of helper T cells. The good responders had higher cell counts than the poor responders, with differences in cell counts between good and poor responders more marked 1 month after beginning treatment, particularly of natural killer cells, cytotoxic T cells, and inducer T cells. These differences disappeared 3 months after the onset of treatment.
Conclusion:
Intravesical BCG therapy caused a marked and persistent alteration of the systemic immunological status.