Th1/Th2 balance: an important indicator of efficacy for intra-arterial chemotherapy.
OBJECTIVE
It has been reported that Th2 cytokines down-regulate antitumor immunity, while activation of type 1 T cells promotes antitumor immunity. However, the immunological features of liver cirrhosis (LC) patients with advanced hepatocellular carcinoma (aHCC) treated by intra-arterial chemotherapy are still unclear. The aim of this study was to assess the influence of intra-arterial combination chemotherapy on the Th1/Th2 balance in LC patients with aHCC.


METHODS
Twenty-one adult Japanese LC patients with aHCC were treated by intra-arterial combination chemotherapy. The control group was composed of 20 adult Japanese patients with chronic hepatitis C diagnosed from examination of liver biopsy specimens. All control patients were over 55 years old and were stage 1 according to the fibrosis score of Desment.


RESULTS
Thirteen of the 21 aHCC patients (group R) showed an objective response, but the other 8 patients (group N) showed no response. There were no significant differences of Th1 cells between group R and group N either before or after chemotherapy. Although there was no significant difference from group R, group N had a significantly higher percentage of Th2 cells than the control group both before and after chemotherapy (p < 0.05 by Tukey's test).


CONCLUSIONS
These results indicate that the Th1/Th2 balance might be a useful indicator of the effect of intra-arterial combination chemotherapy in LC patients with aHCC. Inhibition of an increase of Th2 cells might be important for the efficacy of intra-arterial chemotherapy in such patients.
Nagai
Hidenari
H
Division of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan. hidenari@aol.com
Miyaki
Daisuke
D
Matsui
Teppei
T
Kanayama
Masahiro
M
Higami
Katsuya
K
Momiyama
Kouichi
K
Ikehara
Takashi
T
Watanabe
Manabu
M
Sumino
Yasukiyo
Y
Miki
Kazumasa
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D002945:Cisplatin / Q000008:administration & dosage / Q000494:pharmacology; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000494:pharmacology; D019698:Hepatitis C, Chronic / Q000276:immunology; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000276:immunology; D006801:Humans; D007261:Infusions, Intra-Arterial; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D002955:Leucovorin / Q000008:administration & dosage / Q000494:pharmacology; D008103:Liver Cirrhosis / Q000150:complications / Q000276:immunology; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D018417:Th1 Cells / Q000187:drug effects*; D018418:Th2 Cells / Q000187:drug effects*
C508598:IL4 protein, human; D015847:Interleukin-4; D007371:Interferon-gamma; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil