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Monoclonal antibodies against human T cell adhesion molecules--modulation of immune function in nonhuman primates.

The cytotoxic T cell is thought to be a primary effector of allograft rejection. In vitro studies have demonstrated that the interaction between cytotoxic T cells and target cells involves cell surface adhesion molecules that result in conjugate formation, with subsequent antigen recognition, T cell activation, and target cell lysis. Experiments have also demonstrated the ability of monoclonal antibodies with specificity for two human T cell adhesion molecules, lymphocyte function associated (LFA) antigen-1 (LFA-1, CD11a, alpha-chain/CD18, beta-chain) and LFA-2 (CD2), to inhibit conjugate formation in vitro. Studies in a nonhuman primate model were undertaken to determine whether the in vivo administration of monoclonal antibodies with specificity for the alpha chain of LFA-1 (CD11a) or with specificity for CD2 could modulate in vivo T cell function. Cynomolgus monkeys (Macaca fascicularis) received 10 daily intravenous infusions of either anti-CD11a, anti-CD2 or both anti-CD11a and anti-CD2 monoclonal antibodies. Antibody administration was well tolerated and resulted in high levels of circulating murine monoclonal antibody in the peripheral circulation. Nearly all the animals generated antimurine antibodies that were specific for both idiotypic and nonidiotypic determinants of the infused mouse protein. Circulating lymphocytes and T cells were not depleted by treatment with anti-CD11a or anti-CD2 mAbs; in fact, treatment with the combination of anti-CD11a plus anti-CD2 or anti-CD11a alone led to increased numbers of circulating lymphocytes and T cells. Modulation of the LFA-1 molecule on circulating T cells occurred as a result of treatment with anti-CD11a (or the combination of anti-CD11a plus anti-CD2), whereas treatment with anti-CD2 (or anti-CD11a plus anti-CD2) did not result in modulation of the CD2 antigen despite detectable levels of circulating anti-CD2 mAb. In vivo T cell function was assessed by placement of skin allografts. As compared with treatment with saline or a control mAb, allograft survival was significantly prolonged in animals treated with anti-CD11a or combination treatment but not in animals receiving anti-CD2 alone. We conclude that the in vivo administration of anti-LFA-1 mAb may be useful for the blockade of effector T cell activity during allograft rejection, that saturation of antigen and antigen modulation may be important for efficacy of such antibody effects in vivo, and that monoclonal antibodies with specificity for functionally important T cell surface molecules may alter T cell function in vivo without lymphocyte depletion.

Animals↗

Validation of a new highly standardised, lab-independent whole-blood leukocyte function assay for clinical trials (ILCS).

Physical stress induced in healthy volunteers by the Loughborough intermittent shuttle test (LIST) was used to validate a newly developed whole-blood cell culture system (Instant leukocyte culture system (ILCS). Exercise induced immune modulation was investigated through measurement of cytokine levels after activating leukocytes in peripheral blood ex vivo using the physiologic stimulant lipopolysaccharide (LPS). LPS induced production of three different cytokines, interferon gamma (IFNgamma), interleukin-6 (IL-6), and interleukin-10 (IL-10). IFNgamma levels were significantly decreased (P = 0.02 and P = 0.001 ) and IL-10 levels significantly increased (P= 0.04 and 0.03) after exercise. LPS induced IL-6 production was only marginally further increased by exercise. In conclusion, the ILCS system provided a reliable ex vivo method, showing common as well as subject specific features in the time course of the immune modulation caused by the LIST protocol. This system will be useful for studies of the elderly, where cytokine standardisation is notoriously difficult.

Blood Specimen Collection↗

Immune response modulation in the spontaneously hypertensive rat.

Spontaneously hypertensive male and female rats (SHR) were compared with Wistar/Kyoto (W/K) controls at 15 wk and 80 wk of age. Treatment of the young and old hypertensives with thymosin, fraction 5, lowered the blood pressure within 4 wk of the start of treatment. Following 10 wk of injections, the blood pressures of the hypertensive rats remained at a depressed level for about 6 wk. The thymic hormone raised the depressed spontaneous T-cell rosette formation of the aged hypertensive rat and increased the lymph node T-cell response to the mitogens, Con A and PHA. Thymosin administration over a period of 7 wk increased the size of the aged hypertensive thymus. No similar effect was observed in the W/K. Spleen cell production of prostaglandin E (PgE) was markedly higher in the young hypertensive and immune complex deposition was found in the glomeruli and tubules of the aged SHR kidneys. Thymosin lowered the high level of PgE to normal and decreased the immune complex deposition in the kidney. IgG1 levels were considerably depressed in the SHR as compared to the W/K. Following thymosin administration levels of IgG1 increased 2-fold in both rat strains. Plaque-forming cells from the spleens of the untreated SHR were about 3-fold less than those of the age-matched W/K. Following treatment with thymosin the number of plaque-forming cells of both groups demonstrated a substantial further decrease. Spontaneous hypertension in rats is similar, in certain respects to autoimmune-like diseases in humans with a depression in T-cell activity as well as immune complex deposition; both conditions being altered by exposure to a thymic extract.

Aging↗

Monitoring and modulation of immune reactivity in human transplant recipients.

In this study parameters of humoral antibody (HA) and cell-mediated immunity (CMI) were measured before and after transplant in 44 renal transplant patients. The results indicated that, before transplant, CMI parameters but not HA measurements correlated with early graft rejection crises. In antithymocyte globulin (ATG)-treated patients, a striking loss of early rejection activity occurred which correlated with ablation of T cells in the peripheral blood. ATG-treated patients also had a marked loss of T cell reactivity, as measured by phytohemagglutinin (PHA) blastogenesis and these parameters also correlated with allograft reactivity. Concanavalin A (Con-A) reactivity, however, did not correlate well with early rejection activity. Triple drug therapy with ATG, but not prednisone-Imuran therapy, caused a marked fall of T cell levels and reactivity within hours of the first dose of ATG. None of the ATG-treated patients had irreversible or progressive rejection in the first month after transplant and only 32 percent of patients had rejections, of which more than 70 percent were Type I. A "permissive" level of T cells of about 20 percent of normal was associated with over 95 percent of acute rejection crises, whereas no correlation of a variety of humoral antibody parameters and rejection has been seen in our unit. These studies suggest a primary role of the T cell in early allograft reactivity and indicate that future immunosuppressive techniques for human transplantation should be directed toward effective monitoring and modulation of T cell levels and reactivity in the early post-transplant period.

Antibodies↗

[Dynamics of leukocytes' migration degree in oral cavity and parameters of INFgamma and TNFalpha in blood serum of patients suffering from parodontitis on the background of treatment with Unimag].

In the oral cavity of patients with parodontitis before treatment the quantity of migrated leukocytes (ML) was increased. Among them number of living cells was sharply reduced. In the process of treatment on the background of immune modulation with Unimag, the concentration of migrated leukocytes decreases and number of living leukocytes increases. The above-mentioned quantitative and qualitative parameters of migrated leukocytes were normalized after 1-1.5 months. The analogical dynamics has been detected in patients suffering from parodontitis and treated with traditional scheme. However, despite reduced concentration of migrated leukocytes and increased percentage of living leukocytes' content, normalization of the mentioned parameters has not been detected. In the blood serum of patients suffering from parodontitis increased concentration of INFgamma and TNFalpha have been revealed. In the process of treatment, concentration of the mentioned cytokines was decreased, however, in patients treated with Unimag on the background of immune modulation, decrease in concentration of INFgamma and TNFalpha was much more expressed.

Chemotaxis, Leukocyte↗

Alpha-1-acid (AAG, orosomucoid) glycoprotein: interaction with bacterial lipopolysaccharide and protection from sepsis.

In the acute phase response to a variety of insults a rise in the levels of the acute phase proteins, including elevations of serum alpha 1 acid glycoprotein (AAG) occurs. The physiological role of AAG is unknown, however, the time course of AAG production in the acute phase response together with its strong affinity for basic compounds suggests that AAG may function as an immune modulator to bind both exogenous and endogenous inflammatory mediators. Using E. coli lipopolysaccharide (LPS), an initiator of the acute inflammatory response associated with septic shock, we demonstrate that AAG-LPS complexes can activate mouse macrophages in vitro. In a mouse animal model of sepsis, AAG was shown to protect against meningococcal endotoxin. To pursue the mechanism of AAG action we demonstrated that AAG interacts directly with LPS using dynamic light scattering particle sizing and particle mobility. We also determined the enthalpy of interaction of AAG and LPS and showed that AAG leads to agglutination of LPS impregnated rabbit red blood cells. These studies suggest that AAG may function as an immune-modulator in the acute phase response, possibly by counter-regulating the activity of macrophage pro-inflammatory cytokines.

Animals↗

The enhanced effect of a hexameric deoxyriboguanosine run conjugation to CpG oligodeoxynucleotides on protection against allergic asthma.

BACKGROUND: Oligodeoxynucleotides containing a CpG motif (CpG ODNs), as potent inducers of T(H)1 immunity, are considered promising candidates for immune modulation in asthma. We have previously demonstrated that conjugation of a hexameric deoxyriboguanosine run to the 3' terminus (3' dG(6)-run) of phosphodiester (PE) CpG ODNs enhanced their immuno-stimulatory activities in vitro. OBJECTIVE: This study aimed to evaluate the effect of a 3' dG(6)-run conjugation to PE or phosphorothioate (PS) CpG ODNs on protection against murine allergic asthma in vivo. METHODS: Balb/c mice were sensitized to ovalbumin by intraperitoneal injection with or without CpG ODNs (PS CpG ODNs, PE CpG ODNs, and those with 3' dG(6)-run) and subsequently challenged with ovalbumin. We evaluated airway hyperresponsiveness, eosinophil proportion in bronchoalveolar lavage fluid, airway inflammation, and ovalbumin-specific antibody responses. RESULTS: The conjugation of a 3' dG(6)-run to PE CpG ODNs enhanced the production of IFN-gamma from ovalbumin-specific T(H) cells and prevented the development of asthma in terms of airway hyperresponsiveness, airway eosinophilia, and ovalbumin-specific IgE responses; these effects were comparable to those of PS CpG ODNs. Enhanced effects of the 3' dG(6)-run were also observed in PS CpG ODNs, though they were lower than those in PE CpG ODNs. CONCLUSION: This study suggests that conjugation of a 3' dG(6)-run to CpG ODNs might provide an effective method for immune modulation of allergic asthma.

Animals↗

Pilot study of immunotherapy with interleukin-2 after autologous stem cell transplantation in advanced breast cancers.

Median survival for advanced breast cancer does not exceed 2 years. Immunotherapy following Hihg Dose Chemotherapy (HDC) and autologous stem cell transplantation (ASCT) is a procedure that could hypothetically decrease relapse rate. The mechanism implicated is induction of immune modulation and a possible Graft Versus Tumor effect (GVHT). Tolerance and feasibility of rIL-2 administered after HDC with ASCT was analyzed in twenty one advanced breast cancer patients. The patients were treated either with intra-venous high-dose rIL-2 (9 patients) or subcutaneous low dose (12 patients). With intra-venous high-dose rIL-2, 50% of the scheduled dose was administered and 100% of the scheduled dose was administered at a lower dose in the subcutaneous route. rIL-2 was administered safely after HDC and ASCT, particularly in the subcutaneous low dose arm. However no clinical beneficial effect was documented for these advanced heavily pretreated breast cancers. Immune modulation with rIL-2 earlier requires further investigation.

Adult↗

Pituitary-directed leukemia inhibitory factor transgene causes Cushing's syndrome: neuro-immune-endocrine modulation of pituitary development.

Leukemia inhibitory factor (LIF) regulates the mature hypothalamic-pituitary-adrenal axis in vivo. In vitro, LIF determines corticotroph cell proliferation and induces POMC transcription. To explore LIF action on pituitary development, transgenic mice expressing LIF driven by the pituitary glycoprotein hormone alpha-subunit (alphaGSU) promoter were generated. Transgenic mice exhibited dwarfism with low IGF-I (29 +/- 9 ng/ml vs. wild type (WT) 137 +/- 16 ng/ml; P < 0.001), hypogonadism with low FSH (0.04 +/- 0.023 ng/ml vs. WT 0.63 +/- 0.18 ng/ml; P < 0.001), and Cushingoid features of thin skin and truncal obesity with elevated cortisol levels (86 +/- 22 ng/ml vs. WT 50 +/- 14 ng/ml; P = 0.002). Their pituitary glands showed corticotroph hyperplasia, striking somatotroph and gonadotroph hypoplasia, and multiple Rathke-like cysts lined by ciliated cells. LIF, overexpressed in Rathke's pouch at embryonal day 10, diverts the differentiation stream of hormone-secreting cells toward the corticotroph lineage and ciliated nasopharyngeal-like epithelium. Thus, inappropriate expression of LIF, a neuro-immune interfacing cytokine, plays a key role in the terminal differentiation events of pituitary development and mature pituitary function.

Animals↗

Multiple elements of the allergic arm of the immune response modulate autoimmune demyelination.

Analysis of mRNA from multiple sclerosis lesions revealed increased amounts of transcripts for several genes encoding molecules traditionally associated with allergic responses, including prostaglandin D synthase, histamine receptor type 1 (H1R), platelet activating factor receptor, Ig Fc epsilon receptor 1 (Fc epsilon RI), and tryptase. We now demonstrate that, in the animal model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE), mediated by T helper 1 (Th1) T cells, histamine receptor 1 and 2 (H1R and H2R) are present on inflammatory cells in brain lesions. Th1 cells reactive to myelin proteolipid protein expressed more H1R and less H2R than Th2 cells. Pyrilamine, an H1R antagonist, blocked EAE, and the platelet activating factor receptor antagonist CV6209 reduced the severity of EAE. EAE severity was also decreased in mice with disruption of the genes encoding Ig Fc gamma RIII or both Fc gamma RIII and Fc epsilon RI. Prostaglandin D synthase and tryptase transcripts were elevated in EAE brain. Taken together, these data reveal extensive involvement of elements of the immune response associated with allergy in autoimmune demyelination. The pathogenesis of demyelination must now be viewed as encompassing elements of both Th1 responses and "allergic" responses.

Animals↗

Phytochemicals potentiate interleukin-2 generated lymphokine-activated killer cell cytotoxicity against murine renal cell carcinoma.

The success of adoptive immunotherapy using recombinant interleukin-2 (rIL-2) and lymphokine-activated killer (LAK) cells in several cancers has been hampered by severe toxicity associated with high doses of rIL-2. Methods that reduce the dosage of rIL-2 without loss of clinical efficacy are needed. In this study we determined the in vitro effect of a phytochemical immune modulator, Astragalus membranaceus (AM), and two fractions isolated by high-performance liquid chromatography on the cytotoxicity of rIL-2-generated LAK cells against a murine renal cell carcinoma. Our results indicated a 10-fold potentiation of rIL-2-generated LAK cell cytotoxicity manifested by tumor cell lysis of 88% in the group with 100 U/ml of rIL-2 plus AM versus 86% in the group with 1,000 U/ml of rIL-2 alone. Potentiation was obtained with the purified fractions as well. A significantly reduced number of LAK cells was required to achieve the tumor cytotoxicity after LAK cell generation with rIL-2 plus the phytochemicals as compared with rIL-2 alone. Our data indicate that AM is an effective immune modulator, capable of potentiating in vitro the antitumor activity of rIL-2-generated LAK cells.

Adjuvants, Immunologic↗

Oral administration of HSP-containing E. coli extract OM-89 has suppressive effects in autoimmunity. Regulation of autoimmune processes by modulating peripheral immunity towards hsp's?

OM-89 (Subreum) is an E. coli extract used for oral administration in the treatment of rheumatoid arthritis. It contains bacterial heat shock proteins, namely hsp60 and hsp70, which were shown to be major immunogenic constituents of the drug. Immunity to bacterial heat-shock antigens was shown to be a means of immunomodulation of (experimental) autoimmune disease and possibly inflammation in general. This was demonstrated for mycobacterial hsp60 respectively hsp70 in autoimmune disease models for arthritis, diabetes and encephalitis. Parallel to the effects displayed by immunisation with hsp, oral administration of hsp-containing OM-89 was found to modify autoimmune disease in a number of animal models, such as for arthritis, diabetes and SLE. In rats immunisation with OM-89 was found to lead to proliferative T cell responses to hsp60 and hsp70 of both E. coli and mycobacterial origin. Conversely, immunisation with hsp antigens could induce T cell reactivity specific for OM-89. Given this and the autoimmune disease modulating properties of both hsp and OM-89 it is argued that OM-89 acts via the same mechanism as proposed for hsp: that peripheral tolerance is induced at the level of regulatory T cells with specificity for heat-shock proteins. This may constitute one mode of action for OM-89 as an arthritis suppressive oral drug in man.

Administration, Oral↗

Dioxin-enhanced expression of interleukin-1 beta in human epidermal keratinocytes: potential role in the modulation of immune and inflammatory responses.

Human keratinocytes are an important source of cytokines that participate in inflammatory and immunological processes of the skin. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) has been shown to enhance the expression of the cytokine, interleukin-1 beta (IL-1 beta), in a human keratinocyte cell line. Here we have expanded this observation to primary cultures of normal human epidermal keratinocytes. Treatment of these cells with TCDD resulted in increased expression of IL-1 beta mRNA. Both the magnitude and relative fold increase of levels of IL-1 beta mRNA were affected by specific culture conditions. In specific analyses of each culture medium supplement, bovine pituitary extract (BPE) was shown to exert the greatest effect on both the constitutive and TCDD-inducible expression of IL-1 beta mRNA, and this effect of BPE was shown to be concentration-dependent. These results indicate that, in vitro, enhanced expression of IL-1 beta is a response of normal human epidermal keratinocytes to TCDD and furthermore, that the intensity of this response may be modulated by additional growth factors, including those present in BPE.

Blotting, Northern↗

Fractionated extract of Astragalus membranaceus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2.

Success with rIL-2 immunotherapy of human cancer appears to depend on the administration of high doses which are frequently associated with excessive toxicity. Future use of rIL-2 will require certain modifications based on the use of lower doses of rIL-2 without significant loss of antitumor efficacy. We tested in vitro the possibility of potentiating the activity of rIL-2 in terms of LAK cell generation. We hypothesized that co-incubation of LAK cell precursors with a Chinese herbal extract (F3) of Astragalus membranaceus, (an immune modulator currently under study in our laboratory), along with a low concentration of rIL-2, would generate levels of LAK cell activity equivalent to those generated by high concentrations of rIL-2 alone. We found (1) a 10-fold potentiation of rIL-2 activity manifested by tumor cell-killing activity of 80% resulting from LAK cell generation with F3 plus 100 u/ml of rIL-2 versus 76% generated by 1,000 u/ml of rIL-2 alone; (2) a significant reduction in the number of effector LAK cells required for equicytotoxic reaction following LAK cell generation with F3 plus rIL-2 compared to rIL-2 alone. We conclude that potentiation of antitumor activity mediated by rIL-2 in low concentrations is possible by the concomitant use of another immune modulator such as Astragalus membranaceus.

Adjuvants, Immunologic↗

[F3, a fractionated extract of Astragalus membranaceus, potentiates lymphokine-activated killer cell cytotoxicity generated by low-dose recombinant interleukin-2].

Success with rIL-2 immunotherapy of human cancer appears to depend on the administration of high doses which are frequently associated with excessive toxicity. Future use of rIL-2 will require certain modifications based on the use of lower doses of rIL-2 without significant loss of antitumor efficacy. The authors tested in vitro the possibility of potentiating the activity of rIL-2 in terms of LAK cell generation. The authors hypothesized that co-incubation of LAK cell precursors with a Chinese herbal extract (F3) of Astragalus membranaceus (an immune modulator currently under study in the authors' laboratory), along with a low concentration of rIL-2 would generate levels of LAK cell activity equivalent to those generated by high concentrations of rIL-2 alone. The authors found: (1) a 10-fold potentiation of rIL-2 activity manifested by tumor cell killing activity of 80% resulting from LAK cell generation with F3 plus 100 u/ml of rIL-2 versus 76% generated by 1000 u/ml of rIL-2 alone; (2) a significant reduction in the number of effector LAK cells required for equicytotoxic reaction following LAK cell generation with F3 plus rIL-2 compared to rIL-2 alone. The authors conclude that potentiation of antitumor activity mediated by rIL-2 in low concentrations is possible by the concomitant use of another immune modulator such as Astragalus membranaceus.

Astragalus propinquus↗

Monocyte chemoattractant protein-1 selectively inhibits the acquisition of CD40 ligand-dependent IL-12-producing capacity of monocyte-derived dendritic cells and modulates Th1 immune response.

Accumulating evidence indicates that monocyte chemoattractant protein-1 (MCP-1), a CC chemokine, also displays immunoregulatory functions and may be involved in Th subset differentiation. In this study, we examined the effects of MCP-1 on the cytokine-driven differentiation of monocytes into dendritic cells (DCs), the most potent APCs for naive T cells. We found that DCs generated in the presence of MCP-1 displayed a markedly reduced production of IL-12 in response to CD40 ligand but not in response to Staphylococcus aureus stimulation in the presence or absence of IFN-gamma. The production of IL-10, a potent endogenous IL-12 inhibitor, was not affected by MCP-1. Whereas the inhibitory activity of MCP-1 on IL-12 production by monocytes was sensitive to pertussis toxin, its effects on DC differentiation were pertussis toxin resistant. MCP-1 did not affect the surface phenotype and T cell-stimulating activity of DCs, but most interestingly, naive T cells stimulated with MCP-1-primed DCs produced much less IFN-gamma but the same levels of IL-13. Taken together, our results indicated that MCP-1 modulates the differentiation of monocytes into DCs and may thereby inhibit Th1 cell development.

Adjuvants, Immunologic↗

[Infections of the musculoskeletal system with chronic polyarthritis during a combination therapy with Methotrexate and Leflunomide].

AIM: The long-term results of rheumatoid arthritis are unsatisfactory despite the mono or combination therapy of conventional "disease-modifying antirheumatic drugs". Therefore in the recent past the administration of a combination of Methotrexate with Leflunomide takes place more frequently. To what extent the perioperative infection rate is influenced by the individual immune-modulating drugs, is still disputed and should quantified on the basis the rheumatism orthopaedic patient collective of an orthopaedic university clinic. METHOD: The clinical progresses of patients after operative treatment in the orthopaedic hospital, since introduction of the Leflunomide, were evaluated with regard to perioperative infection. RESULTS: Of 16 patients, who were observed during a period of 1,5 years under a combination therapy by MTX/Leflunomide, three exhibited a heavy infection of the musculoskeletal system. CONCLUSION: The combination of the two above mentioned drugs affects different pathophysiological processes. Synergistic effects in therapy but also with regard to side effects must be expected. First available reports on this combination therapy do not refer to a increased infection/risk. The observation of three serious infections under the combination MTX/Leflunomide prompted us to call attention to this risk. In particular with infection-susceptible bone-surgical operations such a combination of immune-modulating medicines should be employed with caution. The recent literature is discussed.

Antirheumatic Agents↗

[A clinical study on PA-MSHA vaccine used for adjuvant therapy of lymphoma and lung cancer].

The objective of this study was to evaluate the effectiveness and safety of pseudomonas aeruginosa MSHA vaccine (PA-MSHA vaccine) used as an immune modulator. The study was carried out after the design of a non-blind, randomized controlled trial. The malignant lymphoma patients were divided into experiment group (45 cases) and control group (43 cases). Likewise were distributed the lung cancer patients: 44 cases in experiment group and 45 cases in control group. The two experiment groups received chemotherapy + PA-MSHA vaccine. The two control groups were given chemotherapy alone. The results showed that the clinical efficacy rate was 95.56% for the exp. group and 69.77% (P < 0.01) for the control group of the malignant lymphoma cases; the clinical efficacy rate was 59.09% for the exp. group and 42.22% (P < 0.01) for the control group of the lung cancer cases. The infection rate was 17.78% for the exp. group and 37.21% (P < 0.05) for the control group of the malignant lymphoma cases; the infection rate was 15.91% for the exp. group and 40.00% (P < 0.05) for the control group of the lung cancer cases. The comprehensive immune effectiveness rates for the exp. group and control group of the malignant lymphoma cases were 77.78% and 23.26% (P < 0.01) respectively. The comprehensive immune effectiveness rates for the exp. group and control group of the lung cancer cases were 84.09% and 35.56% (P < 0.01) respectively. Adverse reactions were found in 5 cases, of which, one was given medical care while the others automatically recovered. These results indicate that PA-MSHA vaccine, as a new kind of immune modulator, can improve the effectiveness of treatment for tumor with low adverse reaction rate.

Adjuvants, Immunologic↗