Flow Cytometric analysis of Th1 and Th2 cytokines in PBMCs as a parameter of immunological dysfunction in patients of Superficial Transitional cell carcinoma of bladder |
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Authors: | A Agarwal S Verma U Burra N S Murthy N K Mohanty S Saxena |
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Institution: | (1) Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110 029, India;(2) Department of Urology, Safdarjung Hospital Campus, New Delhi, India |
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Abstract: | Transitional cell carcinoma (TCC) is the commonest cancer of the bladder. Although majority of TCC can be diagnosed at an
early stage and removed easily by transurethral resection of tumor (TURT), the management of this carcinoma is complicated
due to frequent recurrences usually within 6 months to one-year period. An imbalance between the Th1 and Th2 immune responses
has been attributed to immune dysregulation in various malignancies. The present study aims to evaluate the Th1 and Th2 balance
in Peripheral Blood Mononuclear Cells of 41 TCC patients (20 recurrent and 21 non-recurrent) using flow cytometry. It also
further assesses immunological and cellular factors influencing the anti-neoplastic activity of the TCC patients and in 21
normal healthy subjects in terms of their cytokine expression and various cell surface markers. The findings of the study
revealed that the cell surface markers CD3+, CD4+ and CD8+ along with NK cells were found to be significantly lower in patients
than healthy controls (p<0.01). The mean percent expression of CD4+ was significantly lower in patients showing recurrence
(23.9±9.84) as compared to patients with non-recurrence (31.1±12.27). The percentage of CD4+T-cells (mean±SD) producing IFN-γ,
IL-2 and TNF-α were statistically significantly reduced in patients (19.1±4.94, 52.3±20.86 and 12.8±4.49) as compared to healthy
controls (23.3±3.67, 67.5±12.0 and 17.6±5.96 respectively), (p<0.01, 0.018, 0.001). On the contrary, the mean levels of IL-4,
IL-6 and IL-10 in patients (63.8±17.01, 60.4±14.79 and 65.7±14.84 respectively) were significantly higher as compared to healthy
controls (24.4±8.77, 26.5±5.28 and 20.6±3.81 respectively), (p<0.001). No statistically significant difference was observed
in the cytokine expression between patients showing recurrence and non-recurrence. Patients with bladder cancer seem to develop
a Th2 dominant status with a deficient type1 immune response. The lymphocyte evaluation along with cytokine measurement can
provide a sensitive and valuable tool for evaluating the function of cell-mediated immunity in these patients and can also
find application in therapeutic monitoring of bladder cancer patients as new targets for immunotherapy. |
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Keywords: | Flow cytometry TCC Cytokines |
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