[Inflammatory pathology in urology. Standardization]

The recognition, identification and management of the many events taking place in relation to an inflammatory response has become a rapidly growing field in medicine over the last few years. In this sense, the progress made in later years in the study of the molecular and cellular mechanisms of tissue inflammatory reactions in sites such as synovial membranes, gut mucosa, vascular endothelium etc, is considered highly relevant. A number of authors conscious of such events work on the standardization of clinical models of the inflammatory responses of genitourinary organs resulting from the action of a variety of harmful events. This review is warranted by the prevalence and morbidity and mortality of inflammatory conditions, as well as the complex work of incorporating to Urology the findings from other Biomedical Sciences.

Interferon-alpha-2b enhances the natural killer activity of patients with transitional cell carcinoma of the bladder

BACKGROUND

Transitional cell carcinoma (TCC) of the bladder is associated with alterations in the immune system of the host. The authors demonstrated that in patients with bladder carcinoma there is a negative correlation between the levels of natural killer (NK) activity and the clinical evolution and pathologic stages of disease.

METHODS

The authors investigated the effect of various doses of recombinant interferon-alpha-2b (IFN-alpha-2b) for variable periods of culture on the nonmajor histocompatibility-restricted cytotoxic activity of peripheral blood mononuclear cells (PBMNC) with or without CD16 and CD3-depleted populations from patients with superficial (confined to the mucosa or lamina propria) and infiltrative (those infiltrating beyond the lamina propria) TCC of the bladder using 4-hour 51-sodium chromate (51Cr)-release cytotoxicity assays against both NK-sensitive (K562) and NK-resistant (JY) tumor target cells.

RESULTS

The normal NK activity detected in PBMNC from patients with superficial TCC of the bladder can be significantly enhanced by short-term (18-hour) incubation with recombinant IFN-alpha (P < 0.05). The depressed NK cytotoxic activity found in PBMNC from patients with infiltrative TCC can also be significantly enhanced, but not normalized, by short-term (18-hour) incubation with recombinant IFN-alpha (P < 0.05). Short-term recombinant IFN-alpha-incubated PBMNC from patients with superficial, but not infiltrative, TCC of the bladder also showed marked cytotoxic activity against NK-resistant target cells. By selection with CD16 or CD3 monoclonal antibodies and complement, it was also found that the precursor and effector lymphocytes of this recombinant IFN-alpha-promoted cytotoxicity belong to NK lineage. In kinetic studies, it was found that the maximal levels of the recombinant IFN-alpha-promoted cytotoxic activity against NK-sensitive and NK-resistant target cells in PBMNC from patients with TCC were reached after 18 hours of culture.

CONCLUSION

Recombinant IFN-alpha can enhance the nonmajor histocompatibility-restricted cytotoxic activity of PBMNC from patients with TCC of the bladder.

Thymostimulin enhances the natural cytotoxic activity of patients with transitional cell carcinoma of the bladder

We have investigated the effect of thymostimulin on the major histocompatibility (MHC) unrestricted cytotoxic activity of peripheral blood mononuclear cells (PBMNC) from patients with superficial transitional cell carcinoma (TCC) of the bladder. PBMNC from patients and healthy controls were incubated in the presence of thymostimulin for varying periods of time (2 or 18 h or 5 days), and were used as effectors against 51Cr-radiolabeled natural killer (NK)-sensitive (K-562) and NK-resistant (JY) target cells in cytotoxic assays. In 6 out of 14 patients analyzed, thymostimulin enhanced the cytotoxic activity of PBMNC against NK-sensitive target cells in a dose-dependent manner. This cytotoxic inducer effect of thymostimulin was maximal after 18 h of culture. Thymostimulin failed to induce lytic activity in PBMNC from TCC patients against NK-resistant target cells. We also found that thymostimulin could synergize with interleukin-2 in inducing non-MHC restricted cytotoxic activity in PBMNC from TCC patients. In conclusion, we have demonstrated that thymostimulin can enhance the natural killer cytotoxic activity of PBMNC from patients with TCC of the bladder.

Immunomodulatory effect of interferon-alpha 2b on natural killer cells and T lymphocytes from patients with transitional cell carcinoma of the bladder

Incubation of peripheral blood mononuclear cells (PBMNC) from patients with transitional cell carcinoma of the bladder, with interferon (IFN-alpha 2b) causes dose-dependent enhancement of natural killer (NK) and cytotoxic activity. Increased lytic activity was also observed against both NK-sensitive and NK-resistant target cells and T lymphocytes from such patients showed altered activity upon incubation with IFN-alpha 2b. Furthermore, intracavitary instillation of IFN-alpha 2b is associated with infiltration of the bladder wall by NK cells and T lymphocytes. Future work will be aimed at investigating the possible prognostic value of these results as related to the therapeutic effect of intracavitary instillation of IFN-alpha 2b.

[Myelolipoma of the adrenal gland: preoperative diagnostic approach]

The presence of a non-functioning tumor of the adrenal gland, which proved to be a myelolipoma, was the reason for a diagnostic approach to its etiology by means of the use of different imaging techniques (conventional radiology, angiography, E.C.O., C.A.T. and N.M.R.). As on most of the occasions, it was a question of a middle-aged patient, in this case a woman, displaying obesity and H.T.A. No symptom could be directly connected with the myelolipoma. We also used the clinical case to carry out a review of the different etiopathogenic and clinical aspects in order to lay down treatment guidelines.