Moro D, Goy A, Nagy-Mignotte H, Brambilla C
Service de Pneumologie, CHU de Grenoble.
Rev Mal Respir. 1990;7(3):195-201.
Progress in genetics now enables the synthesis of molecules acting on the regulation of the immune system which are called cytokines. Currently there are several cytokines, Interferon (IFN), Interleukin 2 (IL2), tumour necrosis factor (TNF) as well as haematopoietic growth factors and these are the object of study in clinical trials. Interferon has already been used in the therapy of hairy cell leukaemia, Kaposi sarcoma associated with AIDS(SIDA) and metastasis of malignant melanoma. Interleukin 2 allows for an increase in the cytotoxic activity of NK cells in producing LAK cells, the lymphocyte infiltrating the tumour (TIL). Therapeutic combinations combining IL2 associated with LAK or of TIL have been evaluated in some private studies. These treatments have shown some interesting response levels on those tumours which are usually resistant, such as malignant melanoma or carcinoma of the kidney. TNF is active in vitro on human tumours; its potential toxicity is important; it is the object of a phase 1 clinical trial. Haematopoietic growth factors, G-CSF and GM-CSF, stimulate the production of leucocytes which will be valuable to correct toxic affects on the marrow during chemotherapy. This will enable chemotherapy to be given at a high dose.
遗传学的进展如今使得能够合成作用于免疫系统调节的分子,即细胞因子。目前有几种细胞因子,如干扰素(IFN)、白细胞介素2(IL2)、肿瘤坏死因子(TNF)以及造血生长因子,这些都是临床试验的研究对象。干扰素已被用于治疗毛细胞白血病、与艾滋病(SIDA)相关的卡波西肉瘤以及恶性黑色素瘤的转移。白细胞介素2可增强NK细胞产生LAK细胞(浸润肿瘤的淋巴细胞,即TIL)时的细胞毒性活性。在一些私人研究中已对将IL2与LAK或TIL联合使用的治疗组合进行了评估。这些治疗方法在那些通常具有抗性的肿瘤,如恶性黑色素瘤或肾癌上显示出了一些有趣的反应水平。TNF在体外对人类肿瘤有活性;其潜在毒性很大;它是一项1期临床试验的研究对象。造血生长因子,即粒细胞集落刺激因子(G-CSF)和粒细胞-巨噬细胞集落刺激因子(GM-CSF),可刺激白细胞的产生,这对于纠正化疗期间对骨髓的毒性作用很有价值。这将使能够给予高剂量的化疗。