Abnormal monocyte function in bladder cancer patients

Mononuclear phagocyte function in head and neck cancer. Chemotactic responsiveness of blood monocytes in correlation between histologic grade of the tumor and infiltration of these cells into the tumor area

The chemotactic responsiveness of peripheral monocytes and the acid-phosphatase activity of tumor-infiltrating macrophages, as well as the ultrastructural appearance, were studied in 40 patients with squamous cell carcinoma of the head and neck. The chemotactic responsiveness was found to be decreased in carcinoma patients, and this value appeared to be positively correlated in individual patients with the number of tumor-infiltrating macrophages, as well as with the histologic grade of the tumor. Patients with poorly differentiated malignancies showed impaired monocyte chemotactic responsiveness and low numbers of tumor-infiltrating macrophages. Macrophages present in the parenchyma of the tumor showed a weak and diffuse pattern of acid phosphatase activity. The acid phosphatase activity of stromal macrophages was much stronger and distributed in foci. Electron microscopic examination of the parenchymal macrophages revealed low numbers of lysosomes and the presence of tumor cell debris in the cytoplasm of the cell, without any sign of a surrounding phagosomal membrane. Together with the weak cytochemical reactivity, this probably indicates the poor functional state of the phagocyte when infiltrated in the parenchyma of the tumor. Low molecular weight factors derived from the tumor are known to decrease chemotactic responsiveness of peripheral monocytes. The poor functional state of the macrophages infiltrated within tumor parenchyma might be explained by assuming that a high concentration of such factors in the near vicinity of malignant cells causes toxic effects in macrophages.

Monocyte dysfunction in human cancer

General immunobiologic studies in cancer patients have stressed measurements of lymphocyte function and have commonly ignored the monocyte-macrophage system. A preliminary study of peripheral blood monocyte-macrophage function was undertaken in a group of 90 cancer patients (18 breast, 32 colon, 13 head and neck, 9 lung, and 18 melanoma) and 70 controls. Studies included enumeration of extractible monocytes (EM), quantitation of differentiation into macrophages (macrophage precursor test: MP), evaluation of antibody-dependent cellular cytotoxicity (ADCC), and spontaneous cellular cytotoxicity (SCC) as measured with human erythrocytes, and measurements of monocyte and serum lysozyme activity. Breast cancer patients had normal profiles. Colon cancer patients showed the most profound abnormalities with decreased EM and MP and increased ADCC and SCC. Patients with Stage I and Stage II melanoma had normal profiles, whereas those with advanced melanoma had significantly decreased MP. This defect was restored in two patients by BCG immunotherapy. Head and neck cancer and benign breast disease patients had decreased EM, whereas patients with lung cancer had increased EM. Monocyte lysozyme production was unchanged in the cancer patients compared to controls. Serum lysozyme levels, however, were significantly increased in patients with cancers of the colon, head and neck, and lung. Although patients with localized breast cancer and melanoma had normal levels, these were increased in both patient groups with advanced disease. It would appear that the source of the increased serum lysozyme is probably not the peripheral blood monocytes, but could have originated in the intra-tumoral or tissue-bound macrophages which were not examined. Selected assays of peripheral blood monocyte function were deranged in certain types of cancer patients but were fully normal in others, and did not show consistent correlations with tumor type or stage. Tissue-bound or intra-tumoral macrophages might provide a more fruitful area for study in these disease categories.

The investigation of cellular and humoral immune reactivity in patients with tumours of the bladder

The authors investigated the cellular immune reactivity by measuring the lymphocyte blast transformation, immune globulins and some glycoproteins in the sera of patients with papilloma and carcinoma of the bladder. They found a change in the cellular immune reactivity, but none in immune globulin concentration. Among the glycoproteins the acute phase reactant proteins changed significantly.

Characterization of Fc receptors associated with human malignant tumors

Fc receptors from human tumors were isolated by sucrose gradient fractionation and affinity chromatography techniques. The isolated Fc receptors showed specificity for IgG(Fc) in the closed chamber hemadsorption technique and also in the inhibition experiments using radiolabeled Fc receptors. The results indicate that Fc receptors isolated from tumor tissue are similar to Fc receptors isolated from normal human spleen, dog macrophages, and peripheral white blood cells (WBCs). However, the Fc receptors isolated from macrophages are more potent inhibitors when compared with tumor, spleen, and peripheral WBC Fc receptors. Also, Fc receptors isolated from the various sources are independent of species specificity.

Levamisole in the treatment of non-invasive and invasive bladder cancer: a preliminary report

We have done a double-blind, randomized, controlled study on 37 patients with transitional cell carcinoma in which levamisole was used as an immune adjuvant in addition to the standard therapy for non-invasive and invasive bladder cancer. Levamisole is administered easily and is well tolerated, especially when compared to other immune adjuvants, such as bacillus Calmette-Guérin or Corynecbacterium parvum. Recall antigens, dinitrochlorobenzene reactivity and total lymphocyte count demonstrated little correlation to the initial stage of disease. Monocyte chemotaxis was increased significantly in patients receiving levamisole. Since our study is ongoing on data exist as yet to make any statement regarding the efficacy of levamisole in the treatment of bladder cancer.