Aerosolized BCG (Tice strain) treatment of bronchogenic carcinoma: phase I study.

Twenty patients with pathologically proved non-resectable bronchogenic carcinoma were treated with 100 aerosolized BCG (Tice strain) doses in addition to conventional treatment. The procedure is based on findings that, generally BCG must be closely associated with neoplastic cells to be effective as an immunotherapeutic agent. Bronchogenic malignancy, usually of mucosal origin, is logically treated in this manner. We report here the findings and developments of 10 patients who were treated at least five times each (for a total of 81 treatments) and pertinent experience relating to these and another 10 patients treated a total of 19 times. Local and systemic reactions were frequent and consisted of fever, cough, dyspnea, nausea, vomiting, anorexia, and malaise. Four of the 20 patients (20%) had reactions with the first treatment; by the fourth treatment 6 of 6 (100%) were affected. Prednisone given prophylactically reduced the intensity and the frequency of reactions. There were no severe side effects, obvious BCG infections, or significant changes in pulmonary or liver functions or hematologic values. No patient acquired purified protein derivative sensitivity, although 3 persons converted other skin tests to positive. There was no improvement in actuarial survival time.

Suppression of cell-mediated immunity after infection with attenuated rubella virus.

The effects of attenuated rubella virus infection upon cell-mediated immunity of human volunteers were studied. The volunteers received the vaccine either by nose drops or by the subcutaneous route. Changes in cell-mediated immunity in terms of delayed cutaneous sensitivity to recall antigens, phytohemagglutination stimulation, and spontaneous migration inhibitory factor-like activity were studied at various time periods after infection. Spontaneous migration inhibitory factor-like activity was studied on supernatants of the lymphocytes obtained from the volunteers and incubated for 72 h in the absence of any antigens. A significant proportion of the volunteers showed suppression of one or more parameters of cell-medicated immunity tested by week 2 of infection compared to the control; however, there was no correlation between suppression of the various parameters studied. No difference was noticed in the incidence of cell-mediated immunity suppression between nose drops and subcutaneous route groups.

Immunosuppression during influenza virus infection.

The effects of a live attenuated influenza vaccine and subsequent challenge with virulent influenza virus on the delayed hypersensitivity skin test, and the in vitro response of lymphocytes were evaluated. Volunteers were skin tested before and after administration of vaccine or placebo and challenge with PPD (a purified protein derivative of Mycobacterium tuberculosis), candida, mumps, and trichophytin, and their lymphocytes were tested for [(3)H]thymidine uptake in response to phytohemagglutin. Of eight volunteers who showed evidence of viral replication after administration of the attenuated vaccine, four had a significant diminution in their skin test response, whereas 8 of 13 volunteers infected with virulent influenza virus showed a diminution. Of the 21 volunteers who were infected with either attenuated or virulent influenza virus, 12 showed suppression of their phytohemagglutin response. None of the volunteers who were given placebo vaccine, or who showed no evidence for viral replication after immunization or challenge, had a suppression of their skin test or phytohemagglutin responses. Although most of the infected volunteers demonstrated suppression of their T-cell function, there was no evidence of a similar suppression of B-cell function.