卡介苗治疗膀胱癌作用机制的研究进展

Progress in research on mechanism of BCG in therapy of bladder cancer

卡介苗(Bacille Calmette-Guerin,BCG)是强毒性牛型结核杆菌在特殊人工培养基上经数年传代所获得的减毒牛型结核杆菌活疫苗,其致病能力有所减弱,但仍保留免疫原性,主要用于结核病的防治。BCG灌注疗法一直被认为是经尿道切除非肌层浸润性膀胱癌(non muscle-invasive bladder cancer,NMIBC)最有效的辅助治疗方法,该方法的机制包括BCG的直接作用和间接作用。直接作用是BCG黏附于膀胱并被细胞内化,从而增加肿瘤细胞中具有细胞毒作用的一氧化氮(NO)产生;间接作用是对免疫系统的激活,包括巨噬细胞、中性粒细胞等,从而使这些细胞发挥肿瘤杀伤功能,该过程也与白细胞介素-2(interlukine-2,IL-2)、IL-8、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、IL-10等细胞因子有关。本文就BCG抗肿瘤作用机制的研究进展作一综述。

Bacille Calmette-Guerin (BCG) is an live attenuated vaccine against Mycobacterium bovis which has been obtained by passage of the highly toxic Mycobacterium tuberculosis on a special artificial medium for several years. It has weaker pathogenicity and remains immunogenesity. It has been mainly used to prevent and treat tuberculosis originally. BCG perfusion therapy has long been considered to be the most effective adjuvant treatment for transurethral resection of non-muscle-invasive bladder cancer (NMIBC). The mechanism of this method includes the direct and indirect effects of BCG. The direct effect is that BCG adheres to the bladder and is internalized by the cells,thereby increasies the production of cytotoxic nitric oxide (NO) in tumor cells. The indirect effect is to activate the immune system including macrophages and neutrophils. Therefore,these cells exert tumor killing function,and the process is also related to cytokines such as IL-2,IL-8,TNF-α and IL-10. This article reviews the progress in research on the anti-tumor mechanism of BCG.