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异丙肌苷在治疗有发展为艾滋病相关综合征(ARC)或艾滋病高风险患者中的免疫恢复特性。

Immunorestorative properties of isoprinosine in the treatment of patients at high risk of developing ARC or AIDS.

作者信息

Bekesi J G, Tsang P H, Wallace J I, Roboz J P

机构信息

Department of Neoplastic Diseases, Mount Sinai School of Medicine and Hospital, City University, New York, N.Y. 10029.

出版信息

J Clin Lab Immunol. 1987 Dec;24(4):155-61.

PMID:2452254
Abstract

We have evaluated the immunomodulatory effects of isoprinosine in a double blind randomized clinical study on 63 immunosuppressed male homosexuals with persistent generalized lymphadenopathy (PGL) or ARC. The subjects received either placebo or isoprinosine at 1 or 3 g/day for 28 days. All subjects were monitored for performance for a one year period. In the 3 g/day treatment group clinical improvement was reported by 52% of the patients in contrast to 15% in the placebo group. Patients receiving 3 g/day isoprinosine showed significant increase in NK cells, a major subset of which bears the Leu 7 surface antigen, and in NK cell function as early as at the termination of treatment. This normalized NK cell property was still evident 5 months after cessation of therapy. Total T lymphocytes and T helper cells also increased in this group and a concomitant reduction was observed in activated T lymphocytes (HLA-DR+). As a direct result of the therapy an increase was found in the Th regulatory (Leu 3+ Leu 8+) cell population resulting in normalization of Th inducer/Th regulatory cell ratio. A concomitant reduction to normal range occurred in Ts effector (Leu 2+ Leu 8-) and functionally activated Ts (Leu 2+ HLA-DR+) cell populations. The kinetics of these effects suggest that isoprinosine stimulates the production of precursor lymphocytes and initiates a process of cell differentiation capable of producing long-term restoration of host immunity.

摘要

我们在一项双盲随机临床研究中评估了异丙肌苷对63名免疫抑制的男性同性恋者的免疫调节作用,这些患者患有持续性全身性淋巴结病(PGL)或艾滋病相关综合征(ARC)。受试者接受安慰剂或1克/天或3克/天的异丙肌苷治疗,为期28天。所有受试者均接受了为期一年的性能监测。在3克/天治疗组中,52%的患者报告有临床改善,而安慰剂组为15%。接受3克/天异丙肌苷治疗的患者,早在治疗结束时,自然杀伤(NK)细胞(其中一个主要亚群带有Leu 7表面抗原)及其功能就有显著增加。在治疗停止5个月后,这种正常化的NK细胞特性仍然明显。该组中总T淋巴细胞和辅助性T细胞也有所增加,同时活化T淋巴细胞(HLA-DR+)减少。作为治疗的直接结果,发现调节性T(Th)细胞(Leu 3+ Leu 8+)群体增加,导致Th诱导细胞/Th调节细胞比例正常化。抑制性T(Ts)效应细胞(Leu 2+ Leu 8-)和功能活化的Ts细胞(Leu 2+ HLA-DR+)群体同时减少至正常范围。这些效应的动力学表明,异丙肌苷刺激前体淋巴细胞的产生,并启动一个细胞分化过程,能够长期恢复宿主免疫力。

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