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A new protocol for multiple inhalation of IFN- successfully treats MDR-TB: a case study

Authors: Grahmann, P. R.1; Braun, R. K.2

Source: The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 6, June 2008 , pp. 636-644(9)

Publisher: International Union Against Tuberculosis and Lung Disease

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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.

Keywords: inhaled IFN-; multidrug-resistant tuberculosis;  T-cells

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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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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