Новые возможности иммунокоррекции убольных раком шейки матки в комплексном лечении

Etiologic role of human papilloma virus in cervical carcinoma is well known so this might be the base of application of interferonogenicimmunomodulators in their complex treatment. Evaluation of the role and place of immunotherapy and immunocorrection in combination treatment is one of the urgent problems in both clinical immunology and oncology. In this study we used one of them – allokin-alpha (alloferon) – together with plasmapheresis which contributes to detoxication and enhancement of the tumor cells` sensitivity to cytostatics in complex treatment of locally advanced cervical cancer patients receiving neoadjuvantpolychemotherapy (NCT). Clinical effect of such treatment was described in our previous studies. The purpose of the present research is to study the effect of the application of immunomodulatorallokin-alpha (A) and plasmapheresis (PP) in complex treatment of cervical cancer patients on their cell-mediated immunity and cytokines` composition in serum. Cervical cancer patients with locally-advanced tumors were divided into two groups. The control one received NCT, the basic one consisted of two subgroups – the 1st one in the course of NCT additionally received procedures of gravitational PP, the 2nd one received NCT, PP and 6 injections of allokin-alpha. Immunological parameters was tested in dynamics by flow cytometry and ELISA. Dynamics of cell-mediated immunity parameters revealed the decrease of CD19 + cells in patients of all the groups, of Treg in both subgroups of the basic group; of lymphocytes, CD3 + and CD8 + cells in patients after NCT + PP; activated CD3 + HLA-DR + cells in patients after NCT + PP + A though the amount of CD8+HLA-DR+ was elevated. When PP was applied CD3 + cells` levels was found to be lower than after additional administration of A. Analysis of the cytokines` levels showed the increase of IL-8 after NCT + PP, but administration of A caused its` decrease. IL-10 level was minimal in patients having received NCT + PP + A. Application of NCT + PP and NCT + PP + A prevented the elevation of inflammatory cytokines` levels (IL-1β and TNFα) which was observed in patients of the control group after the course of neoadjuvant treatment. Such a dynamics of cytokines levels suggests that application of allokin-alpha together with plasmapheresis and neoadjuvant chemotherapy might be useful in complex treatment of cervical cancer patients with locally advanced tumors.