INCREASES IN CD4 T-LYMPHOCYTES WITH INTERMITTENT COURSES OF INTERLEUKIN-2 IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - A PRELIMINARY-STUDY
INCREASES IN CD4 T-LYMPHOCYTES WITH INTERMITTENT COURSES OF INTERLEUKIN-2 IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - A PRELIMINARY-STUDY
复制标题
DOI：
10.1056/nejm199503023320904
复制
发表时间：
1995-03-02
影响因子：
158.5
通讯作者：
LANE, HC
中科院分区：
文献类型：
--
作者：
KOVACS, JA;BASELER, M;LANE, HC
背景。 Interleukin-2 是免疫系统的重要调节细胞因子，对 T 细胞、B 细胞和自然杀伤细胞具有有效作用。在体外，白介素-2可以诱导人类免疫缺陷病毒(HIV)感染者的外周血单核细胞的增殖和分化。方法。我们对 25 名 HIV 感染患者进行了持续输注白细胞介素 2 治疗，剂量为每个间隔 6 至 1800 万国际单位，每 8 周持续 5 天，持续 7 至 25 个月。所有患者还接受了至少一种批准的抗病毒药物。每月监测免疫学和病毒学变量。结果。在 10 名基线 CD4 计数高于 200 每立方毫米的患者中，有 6 名患者接受白细胞介素 2 治疗后，CD4 细胞数量至少增加了 50%。变化范围为每立方毫米 -81 到 +2211 个细胞。 IL-2 治疗导致表达 HLA-DR 的 CD8 淋巴细胞百分比下降，而 IL-2 受体 p55 链呈阳性的 CD4 淋巴细胞百分比增加。每次输注结束时，四名患者的血浆 HIV RNA 水平出现短暂但持续的升高。其余 15 名患者的 CD4 计数为每立方毫米 200 个或更少，白细胞介素 2 治疗与病毒激活增加、免疫学改善很少以及严重的毒性作用相关。结论。对于每立方毫米 CD4 细胞超过 200 个的患者，间歇性使用 IL-2 可以改善与 HIV 感染相关的一些免疫异常。
Background. Interleukin-2 is an important regulatory cytokine of the immune system, with potent effects on T cells, B cells, and natural killer cells. In vitro, interleukin-2 can induce the proliferation and differentiation of peripheral-blood mononuclear cells from patients infected with the human immunodeficiency virus (HIV).Methods. We treated 25 HIV-infected patients with interleukin-2 administered as a continuous infusion at a dosage of 6 to 18 million IU per bay for 5 days every 8 weeks during a period of 7 to 25 months. All patients also received at least one approved antiviral agent. Immunologic and virologic variables were monitored monthly.Results. In 6 of 10 patients with base-line CD4 counts higher than 200 per cubic millimeter, interleukin-2 therapy was associated with at least a 50 percent increase in the number of CD4 cells. Changes ranged from -81 to +2211 cells per cubic millimeter. Interleukin-2 therapy resulted in a decline in the percentage of CD8 lymphocytes expressing HLA-DR and an increase in the percentage of CD4 lymphocytes that were positive for the p55 chain of the interleukin-2 receptor. Four patients had a transient but consistent increase in the plasma HIV RNA level at the end of each infusion. In the remaining 15 patients, who had CD4 counts of 200 or fewer cells per cubic millimeter, interleukin-2 therapy was associated with increased viral activation, few immunologic improvements, and substantial toxic effects.Conclusions. Intermittent courses of interleukin-2 can improve some of the immunologic abnormalities associated with HIV infection in patients with more than 200 CD4 cells per cubic millimeter.