Treatment with interleukin-2 in malignant pleural mesothelioma: immunological and angiogenetic assessment and prognostic impact.

BACKGROUND: Administration of interleukin-2 (IL-2) has shown some effects on malignant pleural mesothelioma (MPM) tumour regression. The purpose of this study was to investigate the ability of IL-2 to modify immunological effector cells and angiogenesis in MPM patients and their prognostic value. METHODS: Tumour-infiltrating lymphocytes (CD4, CD8, Foxp3), mast cells (MCs) (tryptase and chymase), microvessel count (MVC) and VEGF were determined by immunohistochemistry in two series of MPM patients: 60 patients treated with intra-pleural preoperative IL-2 and 33 patients untreated. RESULTS: Tryptase MCs, and CD8 and Foxp3 lymphocytes were significantly increased in the IL-2-treated group, whereas MVC was significantly lower in the same group. Moreover, in the IL-2-treated group, greater tryptase+MCs and greater Foxp3 lymphocytes were associated with improved and poorer clinical outcomes, respectively. Notably, when these two immunological parameters were combined, they predicted outcomes more effectively. CONCLUSIONS: This study showed that IL-2 treatment leads to a significant increase of immunological parameters, concomitantly with a reduction in vasculature, providing new insight into the cancer mechanisms mediated by IL-2. Moreover, these results suggest that tryptase-positive MCs and Foxp3+ lymphocytes predict clinical outcomes in IL-2-treated patients, highlighting the critical role of the inflammatory response in mesothelioma cancer progression.

Detection of a diurnal rhythm in arterial blood pressure in the evaluation of 24-hour antihypertensive therapy.

Uncertainty in defining hypertensive disease makes a prolonged study of blood pressure pattern necessary, using continuous or semicontinuous blood pressure recordings. Its pathophysiological meaning involves data sufficiently indicative of blood pressure profile with reference to the continuous stimulations of different intensity and duration, which are met by subjects both in their daily activities and in the passage from an active life to sleep. Such a parameter is, in fact, an indispensable premise for a correct course of therapy. The aim of our work was at first the detection of a diurnal rhythm in blood pressure, using data obtained in a 24-h ambulatory monitoring away from the conditioning of different activities and daily routine. We have employed three groups of 34 males each. The first group consisted of hypertensive outpatients, while hospitalized subjects comprised the second group. The third group was composed of normal subjects. Furthermore, after finding this system productive, we started studying whether this rhythm of blood pressure could be modified under the influence of a single administered drug dose, and whether information obtained could be easily interpreted. We studied 12 male patients with essential hypertension, which had been untreated. Each patient underwent three 24-h blood pressure ambulatory monitorings. Two different doses of nifedipine (10 and 20 mg) were randomly administered to each of the patients at the beginning of the second and third readings. We observed a significant fall in systolic blood pressure and a minor decrease in diastolic blood pressure after administration of a single 10 mg nifedipine tablet.

Fully automated ambulatory blood pressure in the diagnosis and therapy of hypertension.

Technical characteristics of a fully automatic apparatus for ambulatory semicontinuous blood pressure monitoring are described. Initially, we ascertained the reliability and the fidelity in the reproduction of studied events (blood pressure, heart rate, ECG). Good results were obtained, even in comparison with other methods (blood pressure semiautomatic or invasive monitoring). We then studied the results of the research on 200 hypertensive subjects. The easy applicability of this method allowed us to demonstrate blood pressure variability over a 24-h patient period. We now can evaluate the factors contributing to blood pressure variability and the alterations contributing to the meaning of circadian rhythm. We are now able to comment on the prevalent incidence of organic or neurogenic components in single hypertensive states, the possible coexistence of asymptomatic coronary heart disease, and on the choice and efficacy of hypotensive drugs.