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[在患有可变免疫缺陷综合征(CVID)的患者中进行的使用人白细胞介素-2(n-IL-2)的安慰剂对照、双盲交叉临床试验的初步结果]

[Preliminary results in a placebo-controlled, double-blind crossover clinical trial with human interleukin-2 (n-IL-2) in patients with variable immunodeficiency syndrome (CVID)].

作者信息

Rump J A, Jahreis A, Schlesier M, Stecher S, Dräger R, Struff W G, Peter H H

机构信息

Abteilung Rheumatologie, Medizinische Universitätsklinik Freiburg.

出版信息

Immun Infekt. 1993 Apr;21 Suppl 1:40-2.

PMID:8344690
Abstract

Ten CVID patients with an in vitro defect for IL-2-synthesis were treated for 12 months in a placebo-controlled double-blind crossover therapy study with human natural IL-2 s.c. There were no severe side effects of n-IL-2 recorded. Serum levels of soluble IL-2 receptors were unaffected by the therapy. Serum IL-2 levels were only measurable in single patients during the therapy phase. Since verum and placebo groups did not differ with respect to requirement for intravenous gammaglobulin substitutions, n-IL-2 therapy was uneffective in switching on IgG synthesis in vivo. Nevertheless, there was an elevation in vitro of IgM synthesis in 5 patients and of IgG synthesis in 4 patients during n-IL-2 therapy after stimulation of patients' lymphocytes with staphylococcus aureus Cowan I (SAC) plus n-IL-2 or with Pokeweed Mitogen (PWM) without n-IL-2. Additionally, an elevated IL-2-synthesis in vitro was recorded after OKT3 stimulation for 3 CVID patients. There was a significant reduction of severe infections from 25 during the first 6 months of the study to 7 infections during the following 6 months, in the group of patients which received n-IL-2 first. In the second group, which received placebo first, there were no significant differences between placebo and n-IL-2 therapy phase detectable (25 infections during the first 6 months of the study and 24 severe infections in the second phase).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一项安慰剂对照双盲交叉治疗研究中,对10名白细胞介素-2合成存在体外缺陷的常见变异型免疫缺陷病(CVID)患者进行了为期12个月的皮下注射人天然白细胞介素-2治疗。未记录到天然白细胞介素-2的严重副作用。可溶性白细胞介素-2受体的血清水平不受该治疗影响。在治疗阶段,仅在个别患者中可检测到血清白细胞介素-2水平。由于真药组和安慰剂组在静脉注射丙种球蛋白替代需求方面没有差异,天然白细胞介素-2治疗在体内开启IgG合成方面无效。然而,在用金黄色葡萄球菌考恩I(SAC)加天然白细胞介素-2或用美洲商陆丝裂原(PWM)不加天然白细胞介素-2刺激患者淋巴细胞后,在天然白细胞介素-2治疗期间,5名患者的IgM合成在体外升高,4名患者的IgG合成在体外升高。此外,3名CVID患者在OKT3刺激后记录到体外白细胞介素-2合成升高。在首先接受天然白细胞介素-2治疗的患者组中,严重感染从研究前6个月的25次显著减少到接下来6个月的7次。在首先接受安慰剂治疗的第二组中,未检测到安慰剂和天然白细胞介素-2治疗阶段之间的显著差异(研究前6个月有25次感染,第二阶段有24次严重感染)。(摘要截取自250字)

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