Nathan Steven D, Barnett Scott D, Moran Brian, Helman Donald L, Nicholson Karin, Ahmad Shahzad, Shorr Andrew F
Inova Transplant Center, Inova Fairfax Hospital, Falls Church, VA 22042, USA.
Respiration. 2004 Jan-Feb;71(1):77-82. doi: 10.1159/000075653.
The only proven therapeutic option for idiopathic pulmonary fibrosis (IPF) is lung transplantation. It is biologically plausible that interferon gamma-1b (G-IFN) may halt or even reverse the disease process and therefore prove to be an effective medical therapy. We report our results using this medication in a cohort of patients with a wide range of severity of IPF.
To determine the impact of G-IFN therapy on the progression of disease in patients with IPF.
We performed a retrospective analysis of patients' pulmonary function tests (PFTs), specifically the forced vital capacity (FVC) and the single breath diffusing capacity for carbon dioxide (DLCO). Comparisons of these parameters prior to and after the implementation of therapy were made by generating regression slopes by least-squares equations.
Twenty-two patients qualified for the analysis. For the FVC, comparison of pre- and post-therapy best-fit regression lines demonstrated a significant difference in favor of G-IFN (p<0.015). For the DLCO, a significant difference in favor of gamma interferon therapy was detected in the advanced group (p<0.03). Seventy percent of the patients showed either stabilization or regression of disease in both their FVCs and their DLCO.
G-IFN appears to be an effective new therapy for patients with IPF. Salutary effects on the rate of change in the FVC and DLCO were most apparent in patients with advanced disease. With slowing or reversal in loss of lung function, G-IFN may improve longevity and may have utility as a bridge to lung transplantation in those patients who are appropriate candidates.
特发性肺纤维化（IPF）唯一经证实的治疗选择是肺移植。γ-1b干扰素（G-IFN）有可能阻止甚至逆转疾病进程，从而成为一种有效的药物治疗方法，从生物学角度来看这是合理的。我们报告了在一组病情严重程度各异的IPF患者中使用这种药物的结果。
确定G-IFN治疗对IPF患者疾病进展的影响。
我们对患者的肺功能测试（PFT）进行了回顾性分析，特别是用力肺活量（FVC）和单次呼吸二氧化碳弥散量（DLCO）。通过最小二乘法方程生成回归斜率，对治疗前后这些参数进行比较。
22名患者符合分析条件。对于FVC，治疗前后最佳拟合回归线的比较显示出有利于G-IFN的显著差异（p<0.015）。对于DLCO，在晚期组中检测到有利于γ干扰素治疗的显著差异（p<0.03）。70%的患者在FVC和DLCO方面均显示疾病稳定或好转。
G-IFN似乎是IPF患者的一种有效的新疗法。对FVC和DLCO变化率的有益影响在晚期疾病患者中最为明显。随着肺功能丧失的减缓或逆转，G-IFN可能会延长患者寿命，并且对于那些合适的患者可能作为肺移植的桥梁发挥作用。
