       Document 0285
 DOCN  M9640285
 TI    Immunohistological findings in patients with superficial bladder
       carcinoma after intravesical instillation of keyhole limpet haemocyanin.
 DT    9604
 AU    Jurincic-Winkler C; Metz KA; Beuth J; Engelmann U; Klippel KF;
       Department of Urology, General Hospital Celle, Germany.
 SO    Br J Urol. 1995 Dec;76(6):702-7. Unique Identifier : AIDSLINE
       MED/96138045
 AB    OBJECTIVE: To determine whether keyhole limpet haemocyanin (KLH)
       instilled intravesically improves the local cellular response within the
       bladder wall of patients suffering from superficial bladder carcinoma.
       PATIENTS AND METHODS: Twelve patients (10 men and two women, mean age 67
       years, range 42-85) with superficial carcinomas of the bladder were
       treated for 6 consecutive weeks and then monthly for 1 year with 20 mg
       KLH in 20 mL saline instilled intravesically after complete resection of
       the tumours. Biopsies were taken for immunohistochemical examination
       before treatment and again 6 weeks, 3, 6 and 9 months after treatment.
       Six patients with no evidence of cystitis or malignant bladder disease
       acted as a control group. Immunofluorescent staining of the biopsies was
       performed using monoclonal antibodies to the T-cell markers CD4 and CD8,
       and to CD14 (monocytes), CDw15 (granulocytes), CD19 B-cells (Pan-B),
       CD68 (macrophages) and HLA-DR. Anti-KLH antibody-producing plasma cells
       were detected using a standard technique. A semiquantitative analysis of
       locally infiltrating cell types was performed. RESULTS: After treatment
       with KLH the increase of CD8+ suppressor cells was less pronounced than
       that of CD4+ helper cells. The T-helper/inducer to
       T-suppressor/cytotoxic cell ratio thus altered from 0.8:2.0 before
       treatment to 1.6:2.3 afterwards. Hence, the number of T-helper cells had
       increased considerably, whereas there was only a moderate increase in
       the number of T-suppressor cells. This cellular ratio could be detected
       for 9 months after KLH therapy. The numbers of activated HLA-DR+ immune
       cells in the submucosa and among urothelial cells also increased after
       KLH instillation. The degree of mononuclear cell infiltration of the
       submucosa increased considerably, but granulocyte infiltration was only
       moderate. Lymph follicles with enhanced B-lymphocyte counts were also
       detected. CONCLUSION: Immune-cell infiltration into the urothelium and
       enhanced activation (expression of class II antigens) suggests distinct
       processes of cellular antigen recognition, which could be detected for
       up to 9 months after the beginning of KLH therapy. This may represent a
       basic functional mechanism of KLH therapy.
 DE    Administration, Intravesical  Adult  Aged  Aged, 80 and over  Antigens,
       CD14/IMMUNOLOGY  Bladder Neoplasms/*IMMUNOLOGY/THERAPY  Carcinoma,
       Papillary/*IMMUNOLOGY/THERAPY  CD4-CD8 Ratio  CD4-Positive
       T-Lymphocytes/IMMUNOLOGY  CD8-Positive T-Lymphocytes/IMMUNOLOGY  Female
       Hemocyanin/*ADMINISTRATION & DOSAGE  Human  HLA-DR Antigens/IMMUNOLOGY
       Immunity, Cellular  Immunohistochemistry  Male  Middle Age  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

