A new protocol for multiple inhalation of IFN- successfully treats MDR-TB: a case study
Abstract:SETTING: Aerosolized interferon-gamma (IFN-) leads to transient conversion of sputum smears in multidrug-resistant pulmonary tuberculosis (MDR-TB).
OBJECTIVE: To test long-term conversion of sputum smears using the new Jena protocol.
DESIGN: Four MDR-TB patients were treated with aerosolized recombinant IFN- (rIFN-) twice weekly for 8 weeks and anti-tuberculosis drugs. Patients were monitored clinically and T-cell subpopulations were analyzed.
RESULTS: The treatment was well tolerated. All sputum smears cleared within 6–8 weeks, and radiological signs of recovery lasted in all patients for 73–106 months (the entire follow-up period). Before treatment, a patient with a 20+ year history of TB showed no T-cells; these cells appeared during treatment. The proportion of natural killer (NK) cells was enhanced during treatment and remained elevated. The proportion of CD4+/CD25+ T-cells in the blood rose after treatment and remained elevated at 2 and 10 months afterwards. No significant change in T-cell levels appeared in patients with a shorter history of TB, except for a tendency toward a slight increase in T-cells during treatment.
CONCLUSION: We invite further confirmation, but aerosolized rIFN- plus anti-microbial treatment cured MDR-TB in this case study. The optimal dosing schedule needs to be determined.
Document Type: Regular Paper
Affiliations: 1: Medical Clinics I, Department of Pneumology and Allergology/Immunology, Friedrich-Schiller University, Jena, Germany 2: Thoracic and Cardiovascular Surgery, Medical School, Loyola University, Maywood, Illinois, USA
Publication date: June 1, 2008
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