Kuroda Y, Takashima H, Endo C, Neshige R, Kakigi R
Department of Internal Medicine, Saga Medical School.
Rinsho Shinkeigaku. 1990 Jun;30(6):594-8.
We administered alpha-interferon (alpha-IFN) and gamma-globulin (gamma-gl) to patients with HTLV-I-associated myelopathy (HAM). Patients selected for this study fulfilled the diagnostic criteria of HAM by Osame et al. As for alpha-IFN, 12 patients were injected intramuscularly with a dose of 3 X 10(6) IU/day of alpha-IFN for 28 days. As for gamma-gl, 10 patients were injected intravenously with a dose of 10 g/day of human gamma-gl for 5 days. alpha-IFN exerted therapeutic effects in 7 of 12 patients and gamma-gl in 6 of 10. The therapeutic effects were shown by the improvement in time for a 20-meter walk, muscle power of lower limbs and urinary frequency. All patients having a history of improvement by corticosteroid therapy showed beneficial responses to both treatments with alpha-IFN and gamma-gl. Contrarily, patients who had not improved by corticosteroid therapy did not show any improvement after gamma-gl and alpha-IFN administration. The therapeutic effects of gamma-gl and alpha-IFN were observed predominantly in cases with shorter duration of illness, more marked abnormality in cerebral MRI findings and higher CSF antibody titers to HTLV-I. There was no correlation between the therapeutic efficacy and clinical severity or serum antibody titers to HTLV-I. We conclude that therapies with alpha-IFN and gamma-gl were safe and effective for the treatment of HAM.
我们对成人T细胞白血病病毒I型相关脊髓病（HAM）患者给予了α干扰素（α-IFN）和γ球蛋白（γ-gl）。入选本研究的患者符合小见等人提出的HAM诊断标准。对于α-IFN，12例患者肌肉注射剂量为3×10⁶IU/天的α-IFN，共28天。对于γ-gl，10例患者静脉注射剂量为10g/天的人γ-gl，共5天。α-IFN在12例患者中有7例产生了治疗效果，γ-gl在10例患者中有6例产生了治疗效果。治疗效果表现为20米步行时间、下肢肌力和尿频症状的改善。所有有皮质类固醇治疗改善史的患者对α-IFN和γ-gl两种治疗均有良好反应。相反，皮质类固醇治疗未改善的患者在给予γ-gl和α-IFN后未显示任何改善。γ-gl和α-IFN的治疗效果主要在病程较短、脑MRI表现异常更明显以及脑脊液中HTLV-I抗体滴度较高的病例中观察到。治疗效果与临床严重程度或血清中HTLV-I抗体滴度之间无相关性。我们得出结论，α-IFN和γ-gl治疗对HAM的治疗是安全有效的。
