HER-2多肽负载自体树突状细胞治疗HER-2阳性乳腺癌的初步研究  

The primary effect of vaccination with autologous dendritic cells loaded with Her-2 peptides against Her-2 positive breast cancer

作　　者：杜庆安 丁蓉蓉[2] 蔡凯 江龙委 

机构地区：[1]解放军81医院烧伤整形科,江苏南京210002 [2]解放军81医院门诊部,江苏南京210002 [3]解放军81医院肿瘤生物治疗科,江苏南京210002

出　　处：《东南国防医药》2013年第6期581-584,共4页Military Medical Journal of Southeast China

摘　　要：目的 探讨HER-2多肽负载自体树突状细胞治疗HER-2阳性乳腺癌的安全性和有效性.方法 15例HER-2阳性及HLA-A2阳性的乳腺癌患者（Ⅱ～Ⅲ期）经标准治疗后行HER-2多肽负载自体树突状细胞治疗.检测治疗前后患者外周血淋巴细胞亚群、Th1型和Th2型细胞因子水平,以及IFN-γ分泌型CD8＋T淋巴细胞比例,观察治疗相关毒副反应及近期临床疗效.结果 治疗后外周血CD3＋比例、CD3＋CD4＋比例和CD4＋/CD8＋比值较治疗前明显升高（P〈0.05）,治疗后血清中IL-2、TNF-α、IFN-γ较治疗前明显上升（P〈0.05）,IL-4、IL-10、IL-12无明显变化（P＞0.05）,IL-10/TNF-α比值较治疗前显著下降（P〈0.05）.IFN-γ分泌型CD8＋T淋巴细胞比例较治疗前也显著上升（P〈0.05）.在治疗结束后的随访时间内,15例患者取得了13例病情稳定,2例病情进展的近期临床疗效.所有治疗患者均未出现3～4级不良反应.结论 HER-2阳性乳腺癌行HER-2多肽负载自体树突状细胞治疗是安全可行的,可改善患者细胞免疫功能并提高Th1型细胞因子水平,促进特异性抗肿瘤细胞免疫应答并产生一定临床获益.Objective To investigate the safety and efficacy of vaccination with autologous dendritic cells loaded with Her-2 peptides against Her-2 positive breast cancer after standard therapy. Methods Fifteen HLA-A2 positive and Her-2 positive breast cancer patients （ stage Ⅱ and Ⅲ ） after standard therapy were treated with autologous dendritic cell loaded with Her-2 HLA-A2-restrict- ed peptides. The peripheral blood lymphocyte subsets, Thl type cytokines （IL-2,IL-12,TNF-α,IFN-γ） and Th2 type cytokines （IL-4, IL-10） level in serum, and the blood IFN-γ＋ CD8 ＋ T ratio were examined. Results The percentage of CD3 ＋ and CD3 ＋ CD4 ＋ and ra- tio of CD4 ＋/CD8 ＋ increased significantly（ P 〈 0.05 ） after the vaccination. Serum levels of IL-2, TNF-α and IFN-γ/increased signifi- cantly（ P 〈 0.05 ） after treatment, while serum levels of IL-4, IL-10, and IL-12 showed no obvious change （P 〉 0.05 ）. The IL-10/TNF- α ratio decreased significantly（ P 〈 0.05 ） after the vaccination. The IFN-γ＋ CD8 ＋ T cells also increased significantly（ P 〈 0. 05 ） after the vaccination. No grade 3 - 4 adverse event happened in all cases during treatment. Conclusion Vaccination with autologous dendrit- ic cells loaded with Her-2 peptides against Her-2 positive breast cancer after standard therapy is safe and feasible. This treatment could improve the body~ cellular immune function and elicit Thl immune responses. The increased tumor special cellular immune responses could produce clinical benefits to some degree.

关 键 词：乳腺癌 树突状细胞 多肽 免疫治疗 

分 类 号：R737.9[医药卫生—肿瘤]