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Abstract
Purpose: Glioma induces immune suppression. However, data revealing the immune status in glioma patients with sequential therapeutic interventions is missing. Thus, the study aims at evaluating the sequential immune status of glioma bearing patients (Astrocytoma Grade I to Grade III) receiving conventional therapeutic measures. The results were compared with the immune status of metastatic secondary glioma and meningioma patients where there is minimal immune suppression and the effect of therapeutic intervention on the above score. Methods: Functional immune parameters of peripheral blood lymphocytes were assayed by CD2 receptors enumeration through E-rosetting and lymphocyte cytotoxicity assay and assessing the generation of reactive oxygen species by NBT assay of peripheral blood macrophages in patient groups bearing Astrocytoma (Grade I to Grade III), meningioma and secondary glioma. Results: Patients bearing Astrocytoma (all 3 grades) showed maximum immune suppression as compared to the normal subjects, diseased meningioma controls, and secondary glioma. Therapeutic interventions viz. radiotherapy, surgery and radiotherapy after surgery and chemotherapy could not recover the suppressed activity of the CD2 bearing lymphocytes and that of peripheral blood macrophages. However, therapeutic scheduling could recover the functional activity of the CD8 bearing lymphocytes and the CD56 NK cells from that of tumor bearing patients. Conclusion: Astrocytoma and not meningioma is capable of causing immunesuppression. As the tumor progresses from Grade I to Grade III, a linear reduction in the functional efficacy of immunocytes is seen to occur. Radiotherapy, surgery, and chemotherapy also induces an inhibitory effect towards the host immune system. The inhibitory effect of tumor as well as of therapy were mainly directed towards the CD2 bearing lymphocyte population and the peripheral blood macrophage population.