title: BCG treatment and the importance of an inflammatory response.
abstract: A prospective study was performed on patients with superficial bladder tumour treated with bacillus Calmette-Guérin (BCG). The kinetics of interleukin-6 (IL-6) titres were monitored in urine collected at regular intervals for 24 h during 14 BCG treatments, each consisting of six weekly intravesical instillations. IL-6 titres were quantified with an ELISA system and compared with a bioassay (biologically active IL-6) system. After instillation, urinary IL-6 titres transiently increased, reaching maximum levels between 2 and 6 h after instillation. IL-6 titres appeared to be significantly correlated with an increase of total cells retrieved by bladder washout 3 h after instillation. The kinetics of the weekly maximum biologically active IL-6 titres indicate that three types of BCG-induced response occur: an "early" response starting at the first instillation; a "late" response after the third instillation; or no IL-6 response. The "early" response appeared to be associated, but not strictly correlated, with an IL-2 response. The results suggest that the effectiveness of BCG treatment is determined by two processes, an inflammatory one, followed by a delayed type of hypersensitivity response.
authors.affiliation: Department of Urology, University of Amsterdam, The Netherlands.
authors.forename: D H
authors.initials: DH
authors.lastname: Schamhart
authors.forename: K H
authors.initials: KH
authors.lastname: Kurth
authors.forename: T M
authors.initials: TM
authors.lastname: de Reijke
authors.forename: R
authors.initials: R
authors.lastname: Vleeming
mesh_terms: D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000276:immunology / Q000628:therapy*; D006801:Humans; D006968:Hypersensitivity, Delayed; D007249:Inflammation / Q000209:etiology; D007376:Interleukin-2 / Q000652:urine; D015850:Interleukin-6 / Q000652:urine; D007700:Kinetics; D009092:Mucous Membrane / Q000276:immunology; D001743:Urinary Bladder / Q000276:immunology; D001749:Urinary Bladder Neoplasms / Q000276:immunology / Q000628:therapy*
chemical_list: D001500:BCG Vaccine; D007376:Interleukin-2; D015850:Interleukin-6