Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences , Tehran , Iran .
J Immunotoxicol. 2014 Jan-Mar;11(1):72-7. doi: 10.3109/1547691X.2013.797525. Epub 2013 Jun 14.
Pulmonary problems are among the most common chronic complications of sulfur mustard (SM) intoxication and adversely affect patients' quality-of-life. The present trial investigated the impact of immunotherapy with interferon (IFN)-γ on quality-of-life, respiratory symptoms, and circulating immunologic and oxidative parameters in patients suffering from chronic SM-induced complications. Patients (n = 15) were administered IFNγ (100 μg) every other day for a period of 6 months. Assessment of quality-of-life [using St. George respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT) indices], the severity and frequency of respiratory symptoms, and serum levels of immunologic [including interleukin (IL)-2, IL-4, IL-6, IL-10, IFNγ, calcitonin gene related peptide (CGRP), matrix metallopeptidase (MMP)-9, and tumor necrosis factor (TNF)-α], oxidative stress [malondialdehyde (MDA) as well as total and reduced glutathione, and catalase and superoxide dismutase (SOD) activity], and fibrogenic [transforming growth factor (TGF)-β] parameters were performed at baseline and at trial end. The results indicated that IFNγ therapy is associated with improvements in SGRQ (p < 0.001) and CAT (p < 0.001) scores, decreased severity of cough (p = 0.001), dyspnea (p < 0.001), and morning dyspnea (p < 0.001), reduced frequency of sputum production (p < 0.001) and hemoptysis (p < 0.001), and elevated FEV1 (p = 0.065). Serum levels of IL-4 (p < 0.001), IL-6 (p < 0.001), IL-10 (p < 0.001), CGRP (p < 0.001), MMP-9 (p = 0.001), TNFα (p < 0.001), TGFβ (p < 0.001) and MDA (p = 0.001) were decreased while those of IL-2 (p < 0.001), IFNγ (p < 0.001), and both total (p = 0.005) and reduced glutathione (p = 0.061) increased by the end of the trial. It was concluded that IFNγ has favorable effects on the quality-of-life and alleviates respiratory symptoms in patients suffering from chronic SM-induced pulmonary complications. A modulation of cytokines and oxidative stress appears responsible for the clinical efficacy of IFNγ.
肺部问题是芥子气（SM）中毒后最常见的慢性并发症之一，会对患者的生活质量产生不利影响。本试验研究了干扰素（IFN）-γ免疫疗法对慢性 SM 诱导的并发症患者生活质量、呼吸症状以及循环免疫和氧化参数的影响。将 15 名患者每隔一天给予 IFNγ（100μg），持续 6 个月。使用圣乔治呼吸问卷（SGRQ）和慢性阻塞性肺疾病评估测试（CAT）指数评估生活质量，呼吸症状的严重程度和频率，以及血清中免疫参数[包括白细胞介素（IL）-2、IL-4、IL-6、IL-10、IFNγ、降钙素基因相关肽（CGRP）、基质金属蛋白酶（MMP）-9 和肿瘤坏死因子（TNF）-α]、氧化应激参数[丙二醛（MDA）以及总谷胱甘肽和还原型谷胱甘肽，以及过氧化氢酶和超氧化物歧化酶（SOD）活性]和纤维化参数[转化生长因子（TGF）-β]在基线和试验结束时进行评估。结果表明，IFNγ 治疗与 SGRQ（p<0.001）和 CAT（p<0.001）评分的改善相关，咳嗽（p=0.001）、呼吸困难（p<0.001）和清晨呼吸困难（p<0.001）的严重程度降低，痰量（p<0.001）和咯血（p<0.001）的频率减少，FEV1（p=0.065）升高。血清中 IL-4（p<0.001）、IL-6（p<0.001）、IL-10（p<0.001）、CGRP（p<0.001）、MMP-9（p=0.001）、TNFα（p<0.001）、TGFβ（p<0.001）和 MDA（p=0.001）的水平降低，而 IL-2（p<0.001）、IFNγ（p<0.001）以及总（p=0.005）和还原型谷胱甘肽（p=0.061）的水平升高。综上所述，IFNγ 对慢性 SM 诱导的肺并发症患者的生活质量有良好的影响，并缓解了呼吸症状。细胞因子和氧化应激的调节似乎是 IFNγ 临床疗效的原因。
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