title: Inhalation therapy using a streptococcal preparation (OK-432) against bronchioloalveolar carcinoma of the lung.
abstract: OBJECTIVE
  In order to inhibit the occurrence of airborne metastasis of bronchioloalveolar cell carcinoma (BAC), we tried to activate alveolar macrophages by the inhalation of aerosolized OK-432, which is a heat and penicillin-treated lyophilized preparation of the Su strain of Streptococcus pyogenes.
  
  
  RESULTS
  Alveolar macrophages were obtained from resected specimens of lung cancer patients and cultured for 24 h in the presence of various concentrations of OK-432 (0.001-1 KE/ml). The cytotoxic activity against a lung cancer cell line was augmented in a dose dependent manner and reached a plateau level at 0.1 KE/ml of OK-432. Furthermore, the alveolar macrophages produced various cytokines, i.e., IL-1, TNF-alpha, and IL-6 after 72 h cultivation with 0.1 KE/ml of OK-432. Based on the in vitro experiments, six patients with intrapulmonary metastatic BAC were therefore treated by the inhalation of aerosolized OK-432. All 6 patients inhaled aerosolized OK-432 (0.1 KE/ml) twice a day for 5 days. The inhalation therapy regimen was repeated either weekly or monthly unless the tumor markedly progressed. No adverse events were observed in any patients. Either an augmentation of antitumor cytotoxicity or TNF-alpha production by the alveolar macrophages was observed in the two of three patients examined.
  
  
  CONCLUSIONS
  OK-432 inhalation therapy was found to be safe and thus warrants further investigation to determine its clinical effectiveness for BAC.
authors.affiliation: Department of Thoracic Surgery, National Kyushu Medical Center, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Ichinose
authors.forename: H
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuyama
authors.forename: K
authors.initials: K
authors.lastname: Sugio
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000280:Administration, Inhalation; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008262:Macrophage Activation / Q000187:drug effects; D016676:Macrophages, Alveolar / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects
chemical_list: D000970:Antineoplastic Agents; D010844:Picibanil