Enhancement of polymorphonuclear leukocyte (PMN) function by OK-432

Polymorphonuclear neutrophils and cancer: intense and sustained neutrophilia as a treatment against solid tumors

Polymorphonuclear neutrophils (PMN) are the most abundant circulating immune cells and represent the first line of immune defense against infection. This review of the biomedical literature of the last 40 years shows that they also have a powerful antitumoral effect under certain circumstances. Typically, the microenvironment surrounding a solid tumor possesses many of the characteristics of chronic inflammation, a condition considered very favorable for tumor growth and spread. However, there are many circumstances that shift the chronic inflammatory state toward an acute inflammatory response around a tumor. This shift seems to convert PMN into very efficient anticancer effector cells. Clinical reports of unexpected antitumoral effects linked to the prolonged use of granulocyte colony-stimulating factor, which stimulates an intense and sustained neutrophilia, suggest that an easy way to fight solid tumors would be to encourage the development of intense peritumoral PMN infiltrates. Specifically designed clinical trials are urgently needed to evaluate the safety and efficacy of such drug-induced neutrophilia in patients with solid tumors. This antitumoral role of neutrophils may provide new avenues for the clinical treatment of cancer.

Concomitant chemo-radio-immunotherapy has a lethal therapeutic effect on tongue carcinomas independent of the clinical stage and histological characteristics of the tumor

We examined the effect of concomitant chemo-radio-immunotherapy on 80 patients with tongue carcinoma. Disappearance of the tumor without recurrence was observed in 21 patients (38.9%) in intravenous infusion chemotherapy group (A) and in 20 patients (76.9%) in intra-arterial infusion chemotherapy group (B) (P<0.005). A total of 41 patients (51.3%) were free from the tumor after the combined therapy. Along with the good therapeutic effect, oral function was preserved with minimal impairment of speech and mastication. Tumor stage, the mode of tumor cell invasion and tumor cell differentiation were not correlated with the therapeutic effect. In addition, the expression of p53, p21(Cip1/WAF1) and proliferating cell nuclear antigen did not differ between the patients with lethal and non-lethal effects. The 5-year-survival rate was 56.8% in Group A, 76.9% in Group B and 59.6% overall. Thus, combined chemo-radio-immunotherapy, especially intra-arterial infusion, may bring a universal therapeutic effect in tongue carcinoma regardless of the tumor stage and the expression of cell phase-regulating proteins.

Increased susceptibility to systemic candidiasis in interleukin-6 deficient mice

Interleukin-6 (IL-6) is a multifunctional cytokine that regulates multiple aspects of the innate immune response. It has been recently shown that endogenous IL-6 is crucial for an efficient defence against severe infections with Gram-negative and Gram-positive bacteria. The aim of the present study was to investigate the role of endogenous IL-6 in the defence against infection with the yeast Candida albicans. During experimental candidemia, IL-6 deficient mice (IL-6-/-) had a decreased survival and an increased fungal load in their organs when compared with IL-6+/+ controls, despite increased plasma concentrations of tumour necrosis factor-alpha (TNF), interleukin-1 alpha (IL-1 alpha) and IL-1 beta, IL-6-/- mice were not able to mount an efficient neutrophil response during the infection. When mice were rendered neutropenic by cyclophosphamide, neutropenic IL-6-/- mice were equally susceptible to C. albicans when compared to neutropenic IL-6+/+ mice, implying that neutrophils mediate the beneficial effect of endogenous IL-6. In conclusion, IL-6-/- mice are more susceptible to disseminated candidiasis, and the effect of IL-6 is most likely mediated by neutrophils.

Human pro- and anti-inflammatory cytokine patterns induced by Streptococcus pyogenes erythrogenic (pyrogenic) exotoxin A and C superantigens

The superantigenic streptococcal erythrogenic toxins A and C (ETA/SPEA and ETC/SPEC) elicit the production by human peripheral blood mononuclear cells of substantial amounts of Th1-derived cytokines (interleukin-2 [IL-2] and gamma interferon) as well as anti-inflammatory cytokines (IL-10 and IL-1 receptor antagonist). In contrast, very low levels of IL-4 and no alpha interferon were induced. The production of these cytokines after stimulation with Streptococcus pyogenes heat-killed bacteria and lipopolysaccharide from gram negative bacteria differed qualitatively and quantitatively from that elicited by the superantigens.

Combination chemo-immunotherapy of murine solid tumor with OK-432, G-CSF, IL-2, and chemotherapeutics

An experimental tumor model was previously established in which BALB/c mice could survive the otherwise fatal intraperitoneal (i.p.) inoculation of BAMC-1 fibrosarcoma cells if the mice were treated with five sequential i.p. injections of OK-432 (a potent BRM) starting 2 days after tumor inoculation. In the present study, although a single i.p. injection of OK-432 alone on day 2 was not enough to cure the tumor-bearing mice, a combination therapy, an injection of OK-432 (5 mg/kg) on day 2 followed by injection of G-CSF (50 micrograms/kg) on day 3, could eradicate the tumor cells in more than 80% of the mice. In contrast to this ascites tumor model, solid tumors induced by intradermal transplantation of BAMC-1 tumor cells were resistant to the combined treatments with OK-432 and G-CSF, dying within 60 days. However, when these mice received a combined chemoimmunotherapy with cisplatin, OK-432, G-CSF and IL-2, starting on day 4, the tumors had regressed, and were completely eradicated. When the same treatment was started as late as day 8, no significant therapeutic effect was observed. Even at this advanced stage, however, it was found that a similar chemo-immunotherapy protocol using CAP-D (cyclophosphamide, epirubicin and DWA2114R) in lieu of cisplatin was extremely effective, achieving the eradication of tumors in more than 70% of the mice. These results indicated that the combination therapy with OK-432, G-CSF, IL-2, and chemotherapeutics could achieve a potent anti-tumor effect against the solid tumor, even at the advanced stage. Subsequent experiments using athymic nude mice transplanted with the tumor cells revealed that the same combination therapy showed weak tumor-regressing effects without achieving a complete cure. These results suggest that T-cells are key effectors in this type of chemo-immunotherapy of malignant tumors.