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JNCI Journal of the National Cancer Institute 2003 95(4):316-326; doi:10.1093/jnci/95.4.316
© 2003 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 95, No. 4, 316-326, February 19, 2003
© 2003 Oxford University Press


ARTICLE

Involvement of Toll-Like Receptor 4 Signaling in Interferon-{gamma} Production and Antitumor Effect by Streptococcal Agent OK-432

Masato Okamoto, Tetsuya Oshikawa, Tomoyuki Tano, Go Ohe, Sachiko Furuichi, Hidetomo Nishikawa, Sharif Uddin Ahmed, Sachiko Akashi, Kensuke Miyake, Osamu Takeuchi, Shizuo Akira, Yoichiro Moriya, Shuzo Matsubara, Yoshiki Ryoma, Motoo Saito, Mitsunobu Sato

Affiliations of authors: M. Okamoto, T. Oshikawa, T. Tano, G. Ohe, S. Furuichi, H. Nishikawa, S. U. Ahmed, M. Sato, Second Department of Oral and Maxillofacial Surgery, Tokushima University School of Dentistry, Tokushima, Japan; S. Akashi, K. Miyake, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; O. Takeuchi, S. Akira, Department of Host Defense, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Y. Moriya, S. Matsubara, Y. Ryoma, M. Saito, Product Research Laboratory, Chugai Pharmaceutical Co., Ltd., Tokyo.

Correspondence to: Mitsunobu Sato, D.D.S., Ph.D., Second Department of Oral and Maxillofacial Surgery, Tokushima University School of Dentistry, 3-18-15 Kuramoto-cho, Tokushima 7708504, Japan (e-mail: satomitu{at}dent.tokushima-u.ac.jp).

Background: The streptococcal agent OK-432 has been used for immunotherapy of head and neck cancer, among other malignancies, but its mechanism of action is unknown. Because the Toll-like receptor 4 (TLR4)/MD-2 complex is important in enabling the mammalian immune system to recognize bacterial components, we investigated whether expression of the TLR4 and MD-2 genes is associated with OK-432-induced anticancer immunity. Methods: Peripheral blood mononuclear cells (PBMCs) from 28 patients with head and neck cancer were analyzed for TLR4 and MD-2 mRNA expression by reverse transcription–polymerase chain reaction (RT–PCR) analysis. PBMCs were treated in vitro with OK-432 or with OK-PSA (a lipoteichoic-acid-related molecule that is an active component of OK-432), and interferon-gamma (IFN-{gamma}) mRNA expression, an immune response measure, was analyzed by RT–PCR. Patient sera collected 24 hours after OK-432 administration were examined for IFN-{gamma} protein using an enzyme-linked immunosorbent assay. Lewis lung carcinoma-bearing wild-type C57BL/6 and TLR4-deficient mice (four mice per group) received intraperitoneal injections of OK-432, and tumor volumes and sera IFN-{gamma} levels were measured over time. All statistical tests were two-sided. Results: Twenty patients expressed both TLR4 and MD-2. Expression of TLR4 and MD-2 genes was associated with the in vivo IFN-{gamma} induction in 19 patients administered OK-432 (Fisher's exact test P<.001). Although both OK-432 and OK-PSA induced IFN-{gamma} expression from PBMCs in vitro, expression of TLR4 and MD-2 was associated only with IFN-{gamma} expression induced by OK-PSA (P<.001). In vivo intraperitoneal administration of OK-432 resulted in an increase of IFN-{gamma} in sera from wild-type mice but not in sera from TLR4-deficient mice. Tumors in wild-type mice treated with OK-432 were statistically significantly smaller than those in mice treated with saline (P = .007). By contrast, in TLR4-deficient mice, there was no difference in tumor volume between the two treatment groups. Conclusions: TLR4 and MD-2 may mediate OK-432-induced anticancer immunity.



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