Journal Article

Immunostimulation in the Urinary Bladder by Local Application of <i>Nocardia rubra</i> Cell-Wall Skeletons (Rubratin) and Bacillus Calmette-Guérin as Therapy for Superficial Bladder Cancer: A Comparative Study

Elizabeth C. de Boer, Theo M. De Reijke, Pieter C. N. Vos, Karl-Heinz Kurth and Denis H. J. Schamhart

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue Supplement_3, pages S109-S114
Published in print September 2000 | ISSN: 1058-4838
Published online September 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/314062
Immunostimulation in the Urinary Bladder by Local Application of Nocardia rubra Cell-Wall Skeletons (Rubratin) and Bacillus Calmette-Guérin as Therapy for Superficial Bladder Cancer: A Comparative Study

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Twelve patients with superficial bladder cancer were treated with intravesical instillations of Rubratin (ASTA Pharma AG, Frankfurt, Germany), a cell-wall preparation of Nocardia rubra. The objective was to compare the immunostimulating effect of Rubratin with that of bacillus Calmette-Guérin (BCG). Local immunostimulation was determined by cytokine induction in serially collected urine samples during the first 24 h after each instillation, leukocyte influx into the urine, and phenotypic analysis of the lymphocyte fraction. Levels of Rubratin-induced interleukin (IL)-1β, IL-6, and tumor necrosis factor-α were significantly elevated compared with pretherapy levels. Rubratin induced leukocyte influx into the urine. T-cell activation (IL-2 receptor and human leukocyte antigen-DR expression) can be induced, and CD4 : CD8 cell ratios can be increased. All parameters indicated that Rubratin-induced immunostimulation was less than that associated with BCG. In conclusion, although local Rubratin-induced immunostimulation occurs in a limited number of patients, the amount of immunocompetent cells attracted to the bladder seems to be less than that associated with BCG therapy, thus resulting in lower levels of cytokine production (which may reflect less clinical efficacy).

Journal Article.  4560 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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