Th1/Th2 balances in patients with cancer

恶性疾病患者细胞介导的免疫反应受到抑制是众所周知的，并且其机制早已被研究。据报道，IL-12 是诱导干扰素-γ (IFN-G) 产生的最强免疫调节剂之一，然而，据报道，IL-10（一种免疫抑制性 Th2 细胞因子）在接受 IL-12 治疗的患者中增加。为了了解肿瘤疾病患者中如何存在这种现象，本研究纳入了39名正常志愿者和61名胃癌和结直肠癌患者。研究了金黄色葡萄球菌刺激下外周血单核细胞产生IL-12、植物血凝素刺激下外周血单核细胞产生IFN-G和IL-10的情况。刺激24小时后通过酶免疫测定法测量培养物上清液中每种细胞因子的浓度。 IL-12的产生随着疾病的进展而减少，并且与患者的营养损害相关。与正常供者相比，患者体内IFN-G一致下降，而恶病质患者IL-10则升高。在IL-12刺激下，患者的PBMC产生的IL-10显着高于正常供体，而IFN-G的产生没有差异。因此，似乎有必要通过使用IL-12等细胞因子的免疫治疗来降低Th2反应以获得有效的Th1反应。

A suppression of cell-mediated immune reaction in the patients with malignant diseases is well known and the mechanisms of it has long been studied. IL-12 has been reported as one of the strongest immune modulators that induce a production of interferon-gamma (IFN-G), however, IL-10 which is one of the immune-suppressing Th2 cytokines was reported to increase in the patients treated with IL-12. In order to find how this phenomenon exist in patients with neoplastic diseases, 39 normal volunteer and 61 patients with gastric and colorectal cancer were entered in this study. The ptoduction of IL-12 by peripheral blood mononuclear cells with a stimulation of staphylococcus aureus, those of IFN-G and IL-10 with a stimulation of phytohemagglutinin were studied. The concentrations of each cytokine in culture supernatant was measured by enzyme immunoassay after 24 hours of stimulation. The production of IL-12 were decreased along with a advance of the diseases and it was correlated to a nutritional damage in the patients. Those of IFN-G in the patients was uniformly decreased than those in normal donor, and those of IL-10 was increased in the patients with cachexia. The production of IL-10 by PBMC with a stimulation of IL-12 was significantly higher in the patients than in normal donor and there was no difference in those of IFN-G.Thus it seems to be necessary to decrease Th2 response to obtain an effective Th1 response by immunotherapy using cytokines such as IL-12.