Johnson B J, Bekker L G, Rickman R, Brown S, Lesser M, Ress S, Willcox P, Steyn L, Kaplan G
Laboratory of Cellular Psysiology and Immunology, Rockefeller University, New York, USA.
Tuber Lung Dis. 1997;78(3-4):195-203. doi: 10.1016/s0962-8479(97)90026-5.
Low-dose recombinant human interleukin 2 (rhuIL-2) adjunctive immunotherapy in multidrug resistant tuberculosis (MDR-TB) patients.
Evaluation of the effects of daily versus pulse-administered rhuIL-2 compared to placebo.
MDR-TB patients on best available antituberculous chemotherapy received rhuIL-2 for 30 consecutive days (daily therapy), or for 5 days followed by a 9-day 'rest', for three cycles (pulse therapy). Placebo control patients received diluent. The cumulative total dose of rhuIL-2 given to each patient in either rhuIL-2 treatment group was the same. Patient immunologic, microbiologic, and radiologic responses were compared.
The three treatment schedules induced different results. Immune activation was documented in patients receiving daily rhuIL-2 therapy. Numbers of CD25+ and CD56+ cells in the peripheral blood were increased in these patients, but not in patients receiving pulse rhuIL-2 or placebo. In addition, 5/8 (62%) patients receiving daily rhuIL-2 demonstrated reduced or cleared sputum bacterial load while only 2/7 (28%) pulse rhuIL-2 treated and 2/8 (25%) controls showed bacillary clearance. Chest radiographs of 7/12 (58%) patients receiving daily rhuIL-2 indicated significant improvement over 6 weeks. Only 2/9 (22%) pulse rhuIL-2-treated patients and 5/12(42%) placebo controls showed radiologic improvement.
Daily low dose rhuIL-2 adjunctive treatment stimulates immune activation and may enhance the antimicrobial response in MDR-TB.
低剂量重组人白细胞介素2（rhuIL-2）辅助免疫疗法用于耐多药结核病（MDR-TB）患者。
评估每日给药与脉冲式给药的rhuIL-2与安慰剂相比的效果。
接受最佳可用抗结核化疗的MDR-TB患者连续30天接受rhuIL-2治疗（每日疗法），或接受5天治疗，随后休息9天，共三个周期（脉冲疗法）。安慰剂对照患者接受稀释剂。rhuIL-2治疗组中每位患者接受的rhuIL-2累积总剂量相同。比较患者的免疫、微生物学和影像学反应。
三种治疗方案产生了不同的结果。接受每日rhuIL-2治疗的患者出现免疫激活。这些患者外周血中CD25+和CD56+细胞数量增加，但接受脉冲式rhuIL-2治疗或安慰剂治疗的患者未出现这种情况。此外，接受每日rhuIL-2治疗的患者中有5/8（62%）痰菌载量降低或清除，而接受脉冲式rhuIL-2治疗的患者中只有2/7（28%）、对照组中只有2/8（25%）出现菌清除。接受每日rhuIL-2治疗的患者中有7/12（58%）的胸部X光片显示在6周内有显著改善。接受脉冲式rhuIL-2治疗的患者中只有2/9（22%）、安慰剂对照组中有5/12（42%）出现影像学改善。
每日低剂量rhuIL-2辅助治疗可刺激免疫激活，并可能增强MDR-TB的抗菌反应。
