Lymphokine Production and Lymphocyte Subpopulations in Patients With Head and Neck Squamous Carcinoma

Abstract

\s=b\Prior studies of impaired cellular immune reactivity in patients with head and neck squamous carcinoma (HNSC) suggest that immune deficiency associated with tumor growth may be related, in part, to alterations in immunoregulatory functions. To determine if production of soluble mediators of the immune response (lymphokines) is impaired in patients with HNSC, leukocyte migration inhibition in response to phytohemagglutinin was assessed in 32 patients with HNSC and 29 normal subjects and was correlated with levels of specific peripheral blood lymphocyte subpopulations to determine if quantitative levels of immunoregulatory lymphocyte subpopulations were related to in vitro lymphokine production. In the patients with cancer, leukocyte inhibitory factor production was consistently and significantly impaired and was directly related to levels of T4\ x=req-\ positive (helper/inducer) lymphocytes.Substantial differences in levels of individual subpopulations were not detected among normal subjects and patients with cancer; however, the mean T4/T8 ratio was substantially increased in the patients with cancer. The findings confirm and extend prior observations of impaired cellular immune mechanisms in patients with HNSC and suggest that impaired lymphokine production may be related to quantitative and qualitative alterations in lymphocyte subpopulations. (Arch Otolaryngol 1984;110:731-735) Impai red cellular immunoreactivity has been consistently demon¬ strated in patients with advanced immune deficiencies were character¬ ized by impaired delayed hypersensi¬ tivity1 and decreased T-lymphocyte levels2; however, more recent studies have documented the multifaceted nature of immune deficiencies in these patients. Such abnormalities have included impaired lymphocyte blastogenic response to mitogens,3·4 alterations in macrophage function,5·6 and increased levels of suppressor monocytes,7·8 immmunosuppressive proteins,9 and immune complexes in the blood of these patients.1011 These observations along with correlations of immune reactivity with tumor extent and prognosis have provided rationale for investigations of the mechanisms regulating immune re¬ sponses in anticipation that better characterization of the immune defi¬ ciency associated with head and neck cancer would permit rational design of immunotherapeutic approaches to tumor treatment.

Covalent linking of proteins and cytokines to suture: Enhancing the immune response of head and neck cancer patients

“…Early in the disease process, PBL respond normally to mitogens such as phytohemagglutinin (PHA), concanavalin A (Con A), or other stimuli, whereas with progression of cancer, these responses deteriorate 72,78–87 . Patients with early stage HNSCC have normal T‐cell counts and CD4:CD8 ratios in their peripheral blood, whereas patients with advanced disease have reduced counts, decreased numbers of CD4+ cells, and small reductions in CD8+ cells 77,78,88–94 …”

Histologic and systemic prognosticators for local control and survival in margin‐negative transoral laser microsurgery treated oral cavity squamous cell carcinoma

“…26 The hypothesis exists in the literature that depressed immune function, in general, predates carcinogenesis not only for head and neck squamous cell carcinoma but also for other solid tumors of the lung, esophagus, and cervix. [28][29][30][31] It is therefore intuitive to consider that immune compromise, secondary to innate or iatrogenic immunosuppressive conditions, as documented in our patients, 20,[22][23][24] only worsens preexisting anergy. Even in the absence of any known immune deficiency, patients with head and neck cancer have demonstrated impaired cell-mediated immune responses 32 .…”

Nutritional support and prognosis in patients with head and neck cancer

“…The association between malnutrition and depressed immune function in cancer patients is well known [6]. In patients with head and neck cancer, functional alterations in polymorphonuclear leukocytes, lymphocytes, and monocytes have been documented [7-121. Changes in the number of cytotoxic T cells, natural killer cell activity, macrophage function, and the presence of immune complexes may contribute to a depressed antitumor immune response [8,[11][12][13]. It has been accepted that nutritional repletion, used as an adjunct to antineoplastic therapy, 0 1994 Wiley-Liss, Ine.…”