Rönnblom L E, Alm G V, Oberg K
Interferon Laboratory, Ludwig Institute for Cancer Research, Uppsala, Sweden.
Acta Oncol. 1991;30(4):537-40. doi: 10.3109/02841869109092414.
Several previous reports suggest an association between treatment of patients with interferon-alpha (IFN-alpha) and development of autoantibodies and autoimmune disease. We here summarize the experience from a group of 135 patients with midgut carcinoid tumors treated with natural leukocyte IFN-alpha or recombinant IFN-alpha (rIFN-alpha). An unusual high incidence of antimicrosomal antibodies (MsAb) or anti-thyroglobulin antibodies (TgAb) and thyroid disease manifested as hyperthyroidism, hypothyroidism or a biphasic Hashimoto-like disease was seen, with female predominance. The incidence of antinuclear antibodies (ANA) was also increased, but equally in both sexes. Antibodies to parietal cells were found in 5 cases and 4 patients with pernicious anemia were detected. Two patients developed vasculitis of leukocytoclastic type and one a syndrome resembling systemic lupus erythematosus. Some patients treated with rIFN-alpha develop anti-IFN antibodies. Such antibodies may also be autoantibodies reacting with autologous IFN-alpha. They can neutralize the biologic activity of administrated IFN preparation and cause therapeutic failure. The implications of the various autoimmune manifestations during IFN-alpha treatment are discussed.
此前的多项报告提示，使用α-干扰素（IFN-α）治疗患者与自身抗体及自身免疫性疾病的发生之间存在关联。我们在此总结了一组135例中肠类癌肿瘤患者接受天然白细胞IFN-α或重组IFN-α（rIFN-α）治疗的经验。观察到抗微粒体抗体（MsAb）或抗甲状腺球蛋白抗体（TgAb）以及表现为甲状腺功能亢进、甲状腺功能减退或类似桥本氏病的双相性疾病的发生率异常高，且女性居多。抗核抗体（ANA）的发生率也有所增加，但男女相同。在5例患者中发现了壁细胞抗体，并且检测到4例恶性贫血患者。2例患者发生了白细胞破碎型血管炎，1例出现了类似系统性红斑狼疮的综合征。一些接受rIFN-α治疗的患者会产生抗IFN抗体。此类抗体也可能是与自身IFN-α发生反应的自身抗体。它们可中和所给予的IFN制剂的生物活性并导致治疗失败。本文讨论了IFN-α治疗期间各种自身免疫表现的意义。
