Sundar S, Rosenkaimer F, Lesser M L, Murray H W
Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
J Infect Dis. 1995 Apr;171(4):992-6. doi: 10.1093/infdis/171.4.992.
To determine if cytokine immunotherapy accelerates the response to conventional treatment in visceral leishmaniasis (kala-azar), previously untreated Indian patients were given antimony for 30 days (n = 15) or antimony plus interferon-gamma (IFN-gamma; n = 16). After 10 days, 10 (63%) of 16 patients treated with antimony plus IFN-gamma versus 1 (7%) of 15 randomized to antimony alone were considered cured of parasites (P < .005). On day 20, 14 (93%) of 15 versus 6 (40%) of 15 patients, respectively, were apparent clinical cures (P < .006), and treatment was discontinued early in the 14 IFN-gamma treated responders. Day 30 apparent cure rates (100% vs. 73%) and 6-month ultimate cure responses (87% vs. 60%) were higher in IFN-gamma-treated patients but not statistically different from controls (P > .05). All 13 IFN-gamma-treated subjects who were cured (12 of whom received therapy for 20 days) have remained healthy with follow-up of 14-24 months (mean, 18.9). These results indicate that IFN-gamma successfully accelerates the parasitologic and clinical response to antimony treatment, an effect that should permit shortening the duration of conventional therapy in previously untreated kala-azar.
为了确定细胞因子免疫疗法是否能加速内脏利什曼病（黑热病）患者对传统治疗的反应，研究人员对之前未接受过治疗的印度患者进行了如下分组治疗：15名患者接受为期30天的锑剂治疗，16名患者接受锑剂加干扰素-γ（IFN-γ）治疗。10天后，接受锑剂加IFN-γ治疗的16名患者中有10名（63%）被判定寄生虫清除，而随机接受单纯锑剂治疗的15名患者中只有1名（7%）被判定寄生虫清除（P <.005）。在第20天，接受锑剂治疗的15名患者中有14名（93%）、接受锑剂加IFN-γ治疗的15名患者中有6名（40%）实现了明显的临床治愈（P <.006），并且14名接受IFN-γ治疗的有反应患者提前停止了治疗。接受IFN-γ治疗的患者在第30天的明显治愈率（100%对73%）和6个月的最终治愈率（87%对60%）更高，但与对照组相比无统计学差异（P>.05）。所有13名接受IFN-γ治疗且被治愈的患者（其中12名接受了20天治疗）在14至24个月（平均18.9个月）的随访中均保持健康。这些结果表明，IFN-γ成功加速了对锑剂治疗的寄生虫学和临床反应，这一效果应能缩短既往未治疗的黑热病患者的传统治疗疗程。
