BCG dose reduction by decreasing the instillation frequency: Effects on local Th1/Th2 cytokine responses in a mouse model

Elizabeth C. de Boer, Sietske J. Rooyakkers, Denis H. J. Schamhart, Theo M. de Reijke, Karl-Heinz Kurth

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Scopus)

Abstract

Objectives: Based on the requirement of a Th1 immune response for clinical efficacy, and incited by the arbitrary induction scheme, frequent side effects and the empirical approach in improving BCG immunotherapy for superficial bladder cancer, an alternative intravesical BCG treatment schedule for dose reduction was investigated without compromising Thl cytokine induction in the bladder in a mouse model. Methods: Mice were submitted to 6 weekly BCG instillations and treatment schedules omitting intermediate instillations during this standard scheme. Th1 (IFN-gamma, IL-2, IL-12p40), and Th2 (IL-10, IL-4) cytokine responses in individual mouse bladders were measured by a semi quantitative RT-PCR based method. Results: A schedule of only two BCG instillations, administered in week I and week 6, resulted in induction of at least the same levels of IFN-gamma, IL-2 and IL-12p40 Th1 cytokine mRNA compared to 6 weekly instillations, whereas significantly lower levels of Th2 cytokines IL-10 and IL-4 mRNA were observed. Conclusions: During the 6-week period the intermediate weekly BCG instillations 2, 3, 4, and 5 do not contribute to Th1 cytokine upregulation in the bladder, provided that the BCG dose is sufficient. Whether such a reduced BCG frequency schedule has immunestimulating capacity and therapeutic efficacy associated with less side effects in patients remains to be investigated. (c) 2005 Elsevier B.V. All rights reserved
Original languageEnglish
Pages (from-to)333-338
JournalEuropean Urology
Volume48
Issue number2
DOIs
Publication statusPublished - 2005

Cite this