Subcutaneously administered interferon-gamma for the treatment of multidrug-resistant pulmonary tuberculosis
Subcutaneously administered interferon-gamma for the treatment of multidrug-resistant pulmonary tuberculosis
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DOI：
10.1016/j.ijid.2006.12.004
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发表时间：
2007-09-01
影响因子：
8.4
通讯作者：
Cho, Sang-Nae
中科院分区：
文献类型：
--
作者：
Park, Seung-Kyu;Cho, Sungae;Cho, Sang-Nae
目的：评价干扰素-γ皮下注射治疗慢性及晚期耐多药肺结核(MDR-TB)的临床和实验室疗效。设计：自2002年12月至2003年5月，8例痰涂片和培养持续阳性的MDR-TB患者皮下注射200万国际单位的重组人干扰素-γ，每周3次，共72剂，疗程24周。根据药敏试验和既往治疗史，受试者还接受了包含第二次和第三次抗结核药物的定制药物方案。结果：在研究期间，所有受试者的体重保持稳定或略有下降，连续胸部CT扫描没有一例出现放射学改善。所有患者的痰涂片和培养结果保持阳性，平均培养阳性的时间没有增加(从16.5+/-6.4天增加到11.8+/-4.9天)。在干扰素-γ或IL-10的产生或外周血单核细胞中淋巴细胞的组成方面，细胞介导的免疫反应没有增强。4名患者因不良反应而停止治疗。结论：在慢性和晚期耐多药结核病患者中，皮下注射干扰素-γ治疗没有改善临床、放射学、微生物学或免疫学参数。(C)2007年国际传染病学会。爱思唯尔有限公司出版。保留所有权利。
Objective: We evaluated the clinical and laboratory effects of subcutaneously administered interferon-gamma (IFN-gamma) in the treatment of chronic and advanced multidrug-resistant tuberculosis (MDR-TB).Design: Eight patients with sputum smear and culture persistently positive MDR-TB were subcutaneously administered 2 million international units of recombinant human IFN-gamma three times a week for 24 weeks (72 doses total) between December 2002 and May 2003. Subjects also received a customized drug regimen containing second- and third-time antituberculosis agents based upon drug susceptibility testing and previous treatment history.Results: Body weight remained stable or slightly decreased in all subjects during the study period, and none displayed radiographic improvement on serial chest computed tomography scanning. Sputum smears and cultures remained positive for all patients, and there was no increase in the mean time to yield a positive culture (from 16.5 +/- 6.4 to 11.8 +/- 4.9 days). There was no enhancement of cell-mediated immune responses in terms of production of IFN-gamma or IL-10, or of composition of lymphocytes among peripheral blood mononuclear cells. In four patients, therapy was discontinued because of adverse reactions.Conclusion: In patients with chronic and advanced MDR-TB, subcutaneous IFN-gamma treatment did not result in improvement in clinical, radiologic, microbiologic, or immunologic parameters. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.