Adjuvant interferon gamma in patients with drug - Resistant pulmonary tuberculosis: A pilot study

Benéfico Jurídico Hospital, Havana, Cuba. <>
BMC Infectious Diseases (Impact Factor: 2.61). 11/2004; 4(1):44. DOI: 10.1186/1471-2334-4-44
Source: PubMed


Tuberculosis (TB) is increasing in the world and drug-resistant (DR) disease beckons new treatments.
To evaluate the action of interferon (IFN) gamma as immunoadjuvant to chemotherapy on pulmonary DR-TB patients, a pilot, open label clinical trial was carried out in the Cuban reference ward for the management of this disease. The eight subjects existing in the country at the moment received, as in-patients, 1 x 10(6) IU of recombinant human IFN gamma intramuscularly, daily for one month and then three times per week up to 6 months as adjuvant to the indicated chemotherapy, according to their antibiograms and WHO guidelines. Sputum samples collection for direct smear observation and culture as well as routine clinical and thorax radiography assessments were done monthly.
Sputum smears and cultures became negative for acid-fast-bacilli before three months of treatment in all patients. Lesion size was reduced at the end of 6 months treatment; the lesions disappeared in one case. Clinical improvement was also evident; body mass index increased in general. Interferon gamma was well tolerated. Few adverse events were registered, mostly mild; fever and arthralgias prevailed.
These data suggest that IFN gamma is useful and well tolerated as adjunctive therapy in patients with DR-TB. Further controlled clinical trials are encouraged.

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Available from: Pedro Antonio Lopez-Saura
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    • "They concluded that recombinant IFN-g in combination with directly observed therapy can reduce inflammatory cytokines at the site of infection, improve bacterial clearance from the sputum, and improve constitutional symptoms of tuberculosis disease (Dawson et al., 2009). However, earlier studies did not show a long-term microbiological effect, indicating that additional studies are needed to determine the durability and long-term impact of IFN-g therapy (Giosue et al., 2000; Koh et al., 2004; Suarez-Mendez et al., 2004). Interleukin 2 (IL-2) is another cytokine evaluated for its immunotherapeutic potential. "
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    • "This probably explains our finding that only nebulized rIFN-γ1b and not subcutaneous rIFN-γ1b was successful in clearing the sputum of Mtb and reducing the spontaneous release of inflammatory cytokines in 24 hour BAL supernatants. A pilot study of intramuscular rIFN-γ plus second-line anti-TB drugs over a 6-month period in 8 MDR-TB patients from Cuba showed sputum conversion over 1–3 months and marked improvement of radiographic abnormalities [17]. Giosue and colleagues nebulized IFN-α, a type I interferon, for 2 months as an adjunct in a randomized controlled clinical trial in 20 drug sensitive tuberculosis patients [18]. "
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