title: Late effects of intravesical bacillus Calmette-Guérin immunotherapy on bladder mucosa infiltrating lymphocytes: an immunohistochemical study.
abstract: During intravesical bacillus Calmette-Guérin (BCG) treatment for the prophylaxis of recurrent superficial bladder carcinoma, patients typically show a local inflammatory response involving mainly T lymphocytes, most of which have the helper-induced phenotype (CD4+) (CD4+/CD8+ ratio > 1). To evaluate whether this immunophenotypic profile of the lymphocytes persists also after the completion of this immunotherapy, we examined bladder biopsy specimens during the posttreatment follow-up period of 24 patients, previously submitted to a 2-year BCG administration. The intensity of inflammatory response differed among the patients and in 10 of them even between the scar and the normal mucosa of the bladder. A reversal to the pretreatment CD4+/CD8+ ratio < 1 occurred in the majority of subjects, including the 3 patients with histologically confirmed tumour recurrence. In addition, 11 tumour-free patients showed prevailing CD4+ cells in the scar mucosa and prevailing CD8+ in the normal mucosa of their bladder or vice versa. From these findings it appears that the long-term host response to BCG does not depend exclusively on an intense, long-lasting local mononuclear immune reaction.
authors.affiliation: Division of Urology, City Hospital, Alessandria, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Boccafoschi
authors.forename: F
authors.initials: F
authors.lastname: Montefiore
authors.forename: M
authors.initials: M
authors.lastname: Pavesi
authors.forename: M
authors.initials: M
authors.lastname: Pastormerlo
authors.forename: P G
authors.initials: PG
authors.lastname: Betta
mesh_terms: D001707:Biopsy, Needle; D015704:CD4 Antigens / Q000276:immunology; D016516:CD4-CD8 Ratio; D016009:Chi-Square Distribution; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000473:pathology*; D009163:Mycobacterium bovis / Q000276:immunology*; D012008:Recurrence; D013194:Staining and Labeling; D013601:T-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D001743:Urinary Bladder / Q000187:drug effects / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000517:prevention & control / Q000628:therapy*
chemical_list: D015704:CD4 Antigens