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Humoral response against heat shock proteins and mycobacterial antigens after intravesical treatment with bacillus calmette-guerin in patients with superficial bladder cancer

par Zlotta, Alexandre
Référence British journal of urology, 80, SUPPL. 2, page (45)
Publication Publié, 1997

Article révisé par les pairs

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Résumé :

Few studies are available on antibody response during intravesical BCG immunothcrapy for superficial bladder cancer. We analyzed the evolution in scrum antibody response against the purified protein derivative (PPD) of M.bovis BCG and the heat shock proteins (hsp) recombinant HSP 65, P64 native purified protein, recombinant HSP 70 from M.bovis and recombinant GroEL from E.coli. 42 patients with a superficial TCC, 28 treated with six intravesical BCG instillations and 14 patients used as controls were part of this study. Antibody response was measured with a dot blot assay before BCG, and at six weeks and four months post BCG. Antibody response data at four months post BCG were available in 17 patients. Against PPD a significant increase was already observed at six weeks follow-up. In contrast, IgG antibodies against hsps increased progressively from six weeks to four months post-BCG. A significant increase in IgG antibodies against PPD, HSP 65, P64, GroEL, HSP 70 at four month follow-up was observed in 10/17, 8/17, 10/17, 4/17 and 8/17 patients. IgG increase against P64 at four months follow-up as compared to baseline was significantly correlated with a tumor recurrence since 7 out of 8 patients with recurrent tumors had a very significant increase in antibody production whereas only 1 out of 9 patients without recurrence had a moderate increase (p<0.01). The induction of an antibody response directed against a specific hsp seems to be a significant predictor of tumor recurrence after BCG therapy. Further studies are needed to confirm the place of a specific antimycobacterial antibody response as a clinical prognostic factor.