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The mechanism of action of BCG therapy for bladder cancer--a current perspective.

机译:BCG治疗膀胱癌的作用机理-当前观点

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Bacillus Calmette-Guérin (BCG) has been used to treat non-muscle-invasive bladder cancer for more than 30 years. It is one of the most successful biotherapies for cancer in use. Despite long clinical experience with BCG, the mechanism of its therapeutic effect is still under investigation. Available evidence suggests that urothelial cells (including bladder cancer cells themselves) and cells of the immune system both have crucial roles in the therapeutic antitumour effect of BCG. The possible involvement of bladder cancer cells includes attachment and internalization of BCG, secretion of cytokines and chemokines, and presentation of BCG and/or cancer cell antigens to cells of the immune system. Immune system cell subsets that have potential roles in BCG therapy include CD4(+) and CD8(+) lymphocytes, natural killer cells, granulocytes, macrophages, and dendritic cells. Bladder cancer cells are killed through direct cytotoxicity by these cells, by secretion of soluble factors such as TRAIL (tumour necrosis factor-related apoptosis-inducing ligand), and, to some degree, by the direct action of BCG. Several gaps still exist in our knowledge that should be addressed in future efforts to understand this biotherapy of cancer.
机译:卡介苗芽孢杆菌(BCG)已用于治疗非肌肉浸润性膀胱癌已有30多年的历史了。它是使用中最成功的癌症生物疗法之一。尽管有BCG的长期临床经验,但其治疗作用的机制仍在研究中。现有证据表明,尿路上皮细胞(包括膀胱癌细胞本身)和免疫系统细胞在BCG的治疗性抗肿瘤作用中均具有关键作用。膀胱癌细胞的可能参与包括BCG的附着和内在化,细胞因子和趋化因子的分泌以及BCG和/或癌细胞抗原向免疫系统细胞的呈递。在BCG治疗中具有潜在作用的免疫系统细胞亚群包括CD4(+)和CD8(+)淋巴细胞,自然杀伤细胞,粒细胞,巨噬细胞和树突状细胞。膀胱癌细胞通过这些细胞的直接细胞毒性,通过分泌可溶性因子(例如TRAIL(与肿瘤坏死因子相关的凋亡诱导配体))以及某种程度上通过BCG的直接作用而被杀死。在我们的知识中仍然存在一些差距,需要在以后的努力中理解这些癌症的生物疗法。

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