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Calais da Silva et al.                                                                                                                                    Systemic humoral responses during BCG treatment

           Table 1: List of molecules analyzed in this study
                                                                                   Expression in bladder cancer
            Name                               Function
                                                                                          (methods)
            IL-1β      Important mediator of inflammatory response, involved in a variety of cellular
                       activities, such as cell proliferation, differentiation, and apoptosis. Contributes   Tissue (immunochemistry) [31]
                       to inflammatory pain hypersensitivity
            IL-2       Necessary for T cell growth and function. Stimulates the production of   Present in urine during BCG
                       IL-2 receptors on the surface of other immune effector cells, such as   immunotherapy [32]
                       macrophages and B cells as part of the immune response        tissue (immunochemistry) [31]
            IL-4       Important role in regulating antibody production, hematopoiesis and   Tissue (immunochemistry) [31]
                       inflammation, and the development of effector T cell responses. Moreover,   bladder cancer cell lines [33]
                       promotes tumor development by increasing tumor cell resistance to apoptosis  reduced function-polymorphism is
                                                                                    associated with recurrence [7]
            IL-6       Involved in the acute phase response, T cell proliferation, B cell maturation,   Present in urine during BCG
                       macrophage maturation, and cytotoxic T-cell differentiation. Furthermore,   immunotherapy [32,34]
                       contributes to proliferation of cytotoxic NK cells and promotes the   bladder cancer cell lines [35]
                       differentiation of CD4 T cells into Th2 effector cells and it inhibits Th1
                       differentiation
            IL-10      Pleiotropic effects in immunoregulation and inflammation, down-regulates   inhibitory role in BCG-induced
                       the expression of Th1 cytokines, MHC class II presented antigens, and   macrophage cytotoxicity [36]
                       costimulatory molecules on APCs. It enhances B cell survival, proliferation,
                       and antibody production
            IFN-γ      Critical in innate and adaptive immune responses, with immunostimulatory   Bladder cancer cell line [37]
                       and immunomodulatory effects, especially against viral and intracellular
                       bacteria and participates in tumor control. Promotes Th1 responses, namely
                       activating macrophages
            TNF-α      Involved in systemic inflammation and stimulates the acute phase reaction.   Present in urine [32,38]
                       Regulation of immune cells. Endogenous pyrogen, able to induce fever,   (immunochemistry) [31]
                       apoptotic cell death, sepsis, cachexia, inflammation, and inhibit tumorigenesis   bladder cancer cell line [37]
                       and viral replication                                      reduced function-polymorphism is
                                                                                    associated with recurrence [4]
            CCL2       Known as monocyte chemoattractant protein 1. Displays chemotactic activity   Tissue (RT-PCR) [7]
                       for monocytes and basophils. Implicated in the pathogenesis of diseases
                       characterized by monocytic infiltrates, like psoriasis, rheumatoid arthritis, and
                       atherosclerosis
            CCL3       Known as macrophage inflammatory protein 1 alpha plays a role in acute   Tissue (RT-PCR) [7]
                       inflammatory responses
            CCL8       Known as monocyte chemoattractant protein 2. Chemoattractant which   Tissue (RT-PCR) [7]
                       contributes to the local activation of many different immune cells, including
                       mast cells, eosinophils, basophils, monocytes, T cells, and NK cells involved
                       in the inflammatory response. Contribute to tumor-associated leukocyte
                       infiltration
            IP-10      Chemokine CXCL10. Secreted by several cell types in response to IFN-γ.   Tissue (RT-PCR) [7]
                       Several roles, such as chemoattraction for monocytes/macrophages, T cells,   bladder cancer cell line [37]
                       NK cells, and dendritic cells, promotion of T cell adhesion to endothelial
                       cells, antitumor activity, and inhibition of bone marrow colony formation and
                       angiogenesis
            CXCL9      Known as monokine induced by IFN-γ (MIG). T cell chemoattractant, which is   Tissue (RT-PCR) [7]
                       induced by IFN-γ
            Fas-L      Key effector molecule in cell-mediated cytotoxicity       BAK, LAK cells and PBCs stimulated
                                                                                  with BCG or IL-2 (FACS analysis) [28]
            GNLY       Present in cytotoxic granules of cytotoxic T cells and natural killer cells, with
                       cytolytic and pro-inflammatory functions
            Perf       Key effector molecule in cell-mediated cytotoxicity       BAK, LAK cells, PBCs stimulated with
                                                                                    BCG or IL2 (FACS analysis) [28]
            NOS2A      It is the nitric oxide synthase inducible by certain cytokines. The formed   Polymorphisms [39]
                       product, nitric oxide, is a reactive free radical which acts as a biologic
                       mediator in several processes, including neurotransmission and antimicrobial
                       and antitumoral activities
            HMOX-1     Essential in heme catabolism. Highly expressed in various solid tumors, with   NMIBC tissue specimens (RT-PCR) [27]
                       an important role in rapid tumor growth
            CTLA4      Expressed on the surface of helper and cytotoxic T cells and transmits an
                       inhibitory signal. Functions as an immune checkpoint, downregulating the
                       immune system
           BCG: Bacille Calmette-Guérin; RT-PCR: real time polymerase chain reaction; BAK: BCG-activated killer; LAK: lymphokine-activated killer;
           PBC: peripheral blood cells; FACS: fluorescence-activated cell sorting; NMIBC: non-muscle-invasive bladder cancer; IL: interleukin; IFN:
           interferon; TNF: tumor necrosis factor; IP-10: IFN-γ-inducible protein; Fas-L: Fas ligand; GNLY: granulysin; Perf: perforin; HMOX-1: heme
           oxygenase 1; CTLA4: cytotoxic T lymphocyte antigen-4
            118                                                                        Journal of Cancer Metastasis and Treatment ¦ Volume 3 ¦ July 14, 2017
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