Augmentation of immune activity by elimination of antibody and its implications in cancer

Thoracic duct cannulation in a patient with lung cancer

Previously the authors demonstrated limited effectiveness of tumor specific active immunotherapy adjunct to radical surgery in patients with lung cancer. In order to improve the therapeutic effectiveness, a patient with inoperable lung carcinoma was treated with a radical surgery, tumor vaccination, and "unblocking procedures" which consisted of splenectomy and throacic duct canulation. In vitro studies demonstrated the evidence of sensitization of the patient against his own tumor, removal of blocking factor by the thoracic duct fistual from the circulation.

Inhibition of mixed lymphocyte reaction by thoracic duct lymph: removal of inhibitory effect by thoracic duct drainage in lung cancer

The inhibitory effect of the thoracic duct lymph of a patient with lung cancer on the "one-way" mixed lymphocyte reaction without cytoxicity is unequivocally demonstrated. The effect seems to be dose related. A moderate inhibition of mixed lymphocyte reaction is still observed, even if the responding cells are preincubated in the thoracic duct lymph for 1 hr only prior to the addition of stimulating cells. The inhibitory effect of thoracic duct lymph on the mixed lymphocyte reaction is no longer evident when the material is added 1-4 days after the beginning of culture. These observations suggest that the mechanism of the inhibitory effect of thoracic duct lymph may be a simple attachment of inhibitory factors to the receptor sites on the responding lymphocytes, causing interference in cell to cell interaction. The inhibitory effect of thoracic duct lymph collected 1 week after the thoracic duct drainage on mixed lymphocyte reaction is significantly lower than that of thoracic duct lymph collected at the beginning of the procedure. This indicates that the blocking effect of thoracic duct lymph can be easily removed by this technique; which is technically feasible in man. The interrelationship of the tumor-specific blocking factor, thoracic duct drainage, and tumor growth pattern are discussed with respect to the potential usefulness of this procedure as adjuvant immunotherapy in the management of patients with neoplastic diseases.