Zusammenfassung
Erste Ergebnisse aus klinischen Versuchen mit dem Enzym Neuraminidase machen auf eine neue Art der wirksamen Tumorbehandlung aufmerksam. Eingang in die Klinik fand diese vielversprechende Tumor-Immuntherapie nach erfolgreichen tierexperimentellen Studien an tumortragenden Mäusen, Ratten und Hunden. In einer Übersicht sind die derzeit bekannten und wesentlichen experimentellen und klinischen Ergebnisse über die Tumor-Immuntherapie mit Neuraminidase und die in diesem Zusammenhang notwendigen kritischen Überlegungen dargestellt. Darüberhinaus wird versucht, aus der breiten Vielfalt der biochemischen und biologischen Ergebnisse aus in-vitro Studien die wichtigeren Erkenntnisse auszuwählen, die zum Begreifen der noch weitgehend ungeklärten Wirkungsweise des Enzyms in-vivo beitragen können.
In einem kurzen ersten Abschnitt (1.0) sind die charakteristischen biochemischen Daten des Enzyms Neuraminidase aufgeführt. Der zweite Teil (2.0) enthält etwas ausführlicher die Erkenntnisse über die Wirkung der Neuraminidase auf das Verhalten von behandelten Zellen: Hierbei werden einerseits die biophysikalischen und biochemischen Veränderungen angesprochen sowie die sog. „demaskierenden“ Effekte überdacht und andererseits wird die Wirkung auf die immunologisch antwortenden Zellen erörtert. In einem drittenTeil (3.0) sind die unterschiedlichen Befunde aus Tierexperimenten mit Neuraminidasebehandelten Tumorzellen gegenübergestellt, wobei zwischen Tumortransplantations-Experimenten und Tumortherapie-Versuchen unterschieden wurde. Der letzte Abschnitt (4.0) berichtet über die ersten tumortherapeutischen klinischen Studien mit Neuraminidase-behandelten autologen und homologen Tumorzellen, die zum Teil sehr überraschende und erstaunliche Erfolge erbracht haben.
Auf der Grundlage neuerer Befunde aus der Arbeitsgruppe der Autoren werden frühere, zum Teil widersprechende Ergebnisse aus verschiedenen Arbeitsgruppen kritisch überdacht. Auf die Fragen nach der Veränderung der Antigenität und anderer Zelleigenschaften durch die Abspaltung der membrangebundenen Neuraminsäure, der Adjuvanswirksamkeit von Neuraminidase selbst, der Beziehung zwischen erfolgreicher Therapie und Dosisabhängigkeit zum einen und der Beziehung zwischen unerwünschten Methoden zur Reduktion der Tumormasse und immunologischem Reaktionsvermögen des Tumorträgers zum anderen wird besonders eingegangen.
Summary
Preliminary results of first clinical studies with the enzyme neuraminidase call attention to a new kind of cancer treatment. This promising approach to tumor immunotherapy was entered into the clinical phase as a consequence of successful experimental studies in tumor-bearing mice, rats and dogs. In this review, the presently known and essential results of experimental and clinical studies on tumor immunotherapy by means of neuraminidase are presented as well as some necessary and critical considerations in this context. Moreover, out of a broad variety of results of biochemical and biological in vitro studies, it was attempted to select the more essential knowledge which could contribute to a better understanding of the still rather unclear in vivo mode of action of the enzyme neuraminidase.
In a first brief paragraph (1.0), the biochemically characteristic data of the enzyme neuraminidase is presented. In the second section (2.0), the basic knowledge about the effects of neuraminidase on cell behavior is rather amply contained. Here, on the one hand, the biophysical and biochemical alterations are mentioned, the so-called “unmasking” effects are reconsidered and, on the other hand, the effects on the immunologically responding cell are discussed. In a third section (3.0), the diverse findings from animal experiments using neuraminidase-treated tumor cells are confronted, whereby tumor transplantation experiments and tumor therapy experiments are dealt with separately. The last section (4.0) reports about the first clinical studies with neuraminidase-treated autologous as well as homologous tumor cells, which partly brought about rather surprising and astonishing success.
On the basis of recent findings by the study group of the authors, the more prior and sometimes discrepant results of various groups are critically considered. The problems of alteration of antigenicity and of other properties of cells through splitting off membrane-bound neuraminic acid, the facts of adjuvanticity of neuraminidase itself, the relation of successful therapy to dose dependency as well as the relation of undesirable methods for tumor mass reduction to the immunological responsiveness of the tumor bearer were especially looked into.
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Sedlacek, H.H., Seiler, F.R. & Schwick, H.G. Neuraminidase and tumor immunotherapy. Klin Wochenschr 55, 199–214 (1977). https://doi.org/10.1007/BF01487712
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DOI: https://doi.org/10.1007/BF01487712