CLINICS 2012;67(6):587-590 Cytokine production in advanced head and neck cancer patients Conti-Freitas LC et al. Figure 1 - Control (C), Preoperative (PREOP) and Late Postoperative (LP) IFN-c (pg/ml) levels in the supernatant of non-stimulated lymphocytes cultures and in cultures stimulated with Con-A and BCG. regional dissemination capability and potential participa- tion of the immune system in cancer prognosis in this type of cancer (13). IFN-c is the first detectable cytokine at the immunization site after stimulation with protein antigen and plays a critical role in the activation and regulation of the immune response (14). It is a Th1-specific cytokine and promotes the Th1 response and inhibits the Th2 response. Moreover, IFN- c activates macrophages, leading to the increased produc- tion of pro-inflammatory cytokines, including TNF-a, in response to different stimuli. IFN-c was expressed at lower levels in non-stimulated patient cultures (PREOP and LP) than in control group cultures, confirming that the immune system is impaired in these patients. When the cultures were stimulated with ConA, the secretion of this cytokine was improved, and the increase was greater in the LP group than in the PREOP group. The higher levels of IFN-c secretion by the LP cultures than by the PREOP cultures may be associated with improved nutritional status in the LP period or due to a reduction in smoking. Although the effects of smoking and alcohol abuse on supraglottic laryngeal cancer are not fully clear, some authors have demonstrated that smoking can affect some cytokines, mainly IL-4 (15). Lymphocyte cultures from controls and patients with laryngeal cancer were stimulated with BCG (Table 2). BCG induced a more effective increase in IFN-c production in patient cells (4x increase) than in control cells (1.5x increase). As IFN-c has a potent anti-tumor activity, these data suggest that BCG should be tested further in vivo. Kim (16) observed that in vitro, IL-10 inhibited the destruction of squamous cell carcinoma tumor cells by peritumoral lymphocytes. IL-10 inhibits macrophage differ- entiation and, moreover, inhibits antigen presentation to CD8 T lymphocytes, preventing the effective destruction of tumor cells. Thus, IL-10 acts as a local immunosuppressive factor, Table 2 - Control, preoperative (PREOP), and late postoperative (LP) IL-10 and IFN-c levels in non-stimulated cell cultures and in cultures stimulated with ConA and BCG. Control PREOP LP Nonstimulated cultures 154.86 (32.32-192.8) 27.63 (1.12-140.25) 41.47 (30.03-218.09) IFN-c (pg/ml) ConA Stimulation 23,111.03 (1,577.56-176,197.9) 8,976.98 (887.49-95,346.54) 40,091.64 (4,314.92-157,944.7) Data are reported as the median and (range). ND – not detectable. BCG Stimulation 239.9 (139.83-1,718.08) 116.19 (5.5-3,030.86) 186.47 (27.74-1,459.73) 589 Nonstimulated cultures ND ND ND IL-10 (pg/ml) ConA Stimulation 1,093.48 (119.42-2,222.62) 1,318.25 (362.85-6,262.97) 1,374.09 (739.97-3,714.12) BCG Stimulation 78.63 (0.9-314.62) 392.73 (17.84-624.13) 151.73 (17.38-580.91)