Modulation of
interferon-gamma effect by other drug may enhance its
tumor specific activity. The apoptosis inducing effect of
interferon-gamma and its modulation by
cyclosporin-A or
tacrolimus (FK-506) were investigated in in vitro and ex vivo experiments. We found that a combination of
cyclosporin-A (CsA) and recombinant
interferon-gamma (rIFN-gamma) induced significant apoptosis in all four types of human gastric
carcinoma cells tested but not in normal cells such as human peripheral blood mononuclear cells (PBMCs), human omentum-derived mesothelial cells, or human umbilical vein endothelial cells (HUVECs) in vitro. Apoptosis was also induced by a combination of rIFN-gamma with
FK-506 but not with
rapamycin. Next, the apoptosis-inducing effect of endogenous IFN-gamma combined with
cyclosporin-A was examined using clinical samples. A
streptococcal preparation, OK-432, was administered intraperitoneally for the management of 12
gastric cancer patients with malignant
ascites. None of the gascitic fluids obtained before the
OK-432 injection showed detectable IFN-gamma level. The
OK-432 injection induced a detectable IFN-gamma production ranging from 6 to 89 pg/mL in ascitic fluids from 9 out of the 12 patients. A combination of CsA with ascitic fluids collected after but not before
OK-432 injection induced significant apoptosis in MK-1 cells, a gastric
carcinoma cell line. A positive correlation was found between the IFN-gamma level and CsA-induced apoptosis. The CsA-induced apoptosis was also blocked by a specific antibody against human IFN-gamma. These results indicated that both recombinant and endogenous IFN-gamma can induce potent
tumor-apoptosis when combined with CsA.