title: Predominance of TH1 response in tumor-bearing mice and cancer patients treated with AS101.
abstract: BACKGROUND
  Several studies have recently suggested that the immune response to malignant growths is regulated by distinct patterns of type 2 cytokine production. These cytokines, regulating the cytotoxic T-lymphocyte response in patients with advanced cancers, may be associated with disease progression. Evidence suggests that the T Helper 1 (TH1) and T Helper 2 (TH2) types of reaction are reciprocally regulated in vivo. The immunomodulator AS101 (ammonium trichloro[dioxoethylene-O,O']tellurate) was found to stimulate mouse and human cells to proliferate and secrete a variety of cytokines. Clinical trials using AS101 on cancer patients are now in progress.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the ability of AS101 to modulate TH1 and TH2 responses in tumor-bearing mice and in patients with advanced cancer. In addition, we investigated the association between the predominance of each type of response with the antitumoral effects of AS101.
  
  
  METHODS
  Mice into which Lewis lung carcinoma (3LL) had been transplanted (n = 221) and cancer patients (n = 13) were treated with AS101 on alternate days, at 10 micrograms/mouse intraperitoneally, or for the patients, at 3 mg/m2 intravenously. The types were sarcoma, melanoma, and colon, lung, ovarian, and renal cancers. Cytokine levels were determined by immunoassay kits and compared with the paired Student's t test: in mice, they were tested in spleen cell supernatants; in humans, in sera and mononuclear cell supernatants. The chi-squared test was used to compare tumor volumes. All P values represent two-sided tests of statistical significance.
  
  
  RESULTS
  Our results show that treatment of mice and patients with AS101 results in a clear predominance in TH1 responses, with a concomitant decrease in the TH2-type response. This was reflected by a significant enhancement in interleukin 2 (IL-2) and interferon gamma (IFN gamma) levels (P < .01) paralleled by a substantial decrease in IL-4 and IL-10 (P < .01). Moreover, the concentration of IL-12 was significantly increased (P < .01) in AS101-treated patients who also showed enhanced levels of natural and lymphokine-activated killer cell-mediated cytotoxicity. The statistically significant increases in IL-2 and IFN gamma levels, paralleled by the pronounced decrease in IL-4 and IL-10 in the AS101-treated mice, were associated with its antitumoral effects. In addition, systemic cotreatment of 3LL-transplanted mice with AS101 and anti-IL-12 antibodies partly abrogated the antitumoral effect of AS101.
  
  
  CONCLUSIONS
  Immunotherapy with AS101 enhances TH1 function while interfering with the TH2 response. This TH1 trend may be related to the antitumor effects of AS101.
  
  
  CONCLUSIONS
  Isolation and characterization of a distinct cytokine pattern in patients with advanced cancer treated with AS101 may contribute to the development of intervention strategies using this compound.
authors.affiliation: Marilyn Finkler Cancer Research Center, Department of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Sredni
authors.forename: T
authors.initials: T
authors.lastname: Tichler
authors.forename: A
authors.initials: A
authors.lastname: Shani
authors.forename: R
authors.initials: R
authors.lastname: Catane
authors.forename: B
authors.initials: B
authors.lastname: Kaufman
authors.forename: G
authors.initials: G
authors.lastname: Strassmann
authors.forename: M
authors.initials: M
authors.lastname: Albeck
authors.forename: Y
authors.initials: Y
authors.lastname: Kalechman
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018827:Carcinoma, Lewis Lung / Q000188:drug therapy* / Q000276:immunology; D002455:Cell Division / Q000187:drug effects; D016207:Cytokines / Q000097:blood* / Q000187:drug effects; D005030:Ethylenes / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D018664:Interleukin-12 / Q000097:blood / Q000502:physiology; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015979:Killer Cells, Lymphokine-Activated / Q000187:drug effects; D007694:Killer Cells, Natural / Q000187:drug effects*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D009368:Neoplasm Transplantation; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D009374:Neoplasms, Experimental / Q000188:drug therapy* / Q000276:immunology; D013154:Spleen / Q000166:cytology / Q000378:metabolism
chemical_list: D000276:Adjuvants, Immunologic; D000970:Antineoplastic Agents; D016207:Cytokines; D005030:Ethylenes; D007376:Interleukin-2; D016753:Interleukin-10; D018664:Interleukin-12; D015847:Interleukin-4; C054105:ammonium trichloro(dioxoethylene-O,O'-)tellurate; D007371:Interferon-gamma