Giosué S, Casarini M, Alemanno L, Galluccio G, Mattia P, Pedicelli G, Rebek L, Bisetti A, Ameglio F
Department of Cardiovascular and Respiratory Sciences, Lazzaro Spallanzani Institute, Instituto di Ricovero e Cura a Carattere Scientifico, La Sapienza University, Rome, Italy.
Am J Respir Crit Care Med. 1998 Oct;158(4):1156-62. doi: 10.1164/ajrccm.158.4.9803065.
Interferon-alpha (IFN-alpha) is a cytokine exerting pleiotropic activities, including antimicrobial effects, especially directed against intracellular infectious bacteria. It may be administered by aerosol to reach the lower respiratory tract without systemic side effects. The aim of the study reported here was the evaluation of aerosolized IFN-alpha treatment (3 MU/dose, given three times a week; total study dose: 72 MU/2 mo) in combination with conventional antimycobacterial therapy in patients with pulmonary tuberculosis. Two groups of 10 patients each were compared before and after 2 mo of conventional antituberculous chemotherapy with or without inhaled IFN-alpha. Several biologic (bronchoalveolar lavage fluid [BALF] cellularity, Mycobacterium tuberculosis [MT] number in sputum), biochemical (BALF concentrations of 10 cytokines, BALF IFN-alpha receptor levels), and clinical (fever, vital signs, high-resolution computed tomography [HRCT] images) measures were made in these patients at the time of their enrollment and at the end of the observation period of the study. Fever, MT number in sputum, and abnormalities in HRCT images showed significantly earlier resolution in the IFN-alpha-treated group, together with a more significant decrease in BALF interleukin-1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha (TNF-alpha) concentrations and significantly greater pre- versus posttreatment variations in IL-2 and IFN-gamma. These data, taken together, suggest that IFN-alpha administration may favorably affect the evolution of pulmonary tuberculosis when combined with antimycobacterial therapy.
α干扰素（IFN-α）是一种具有多种生物学活性的细胞因子，包括抗菌作用，尤其针对细胞内感染性细菌。它可以通过气溶胶给药，从而到达下呼吸道且无全身副作用。本文报道的这项研究旨在评估雾化吸入IFN-α治疗（3MU/剂量，每周给药3次；总研究剂量：72MU/2个月）联合传统抗分枝杆菌疗法用于肺结核患者的疗效。将两组各10例患者在接受2个月的传统抗结核化疗（一组联合吸入IFN-α，另一组不联合）前后进行比较。在这些患者入组时和研究观察期结束时，进行了多项生物学指标（支气管肺泡灌洗 [BALF] 细胞计数、痰液中结核分枝杆菌 [MT] 数量）、生化指标（BALF中10种细胞因子的浓度、BALF中IFN-α受体水平）以及临床指标（发热、生命体征、高分辨率计算机断层扫描 [HRCT] 图像）的检测。结果显示，IFN-α治疗组发热、痰液中MT数量以及HRCT图像异常的缓解明显更早出现，同时BALF中白细胞介素-1β（IL-1β）、IL-6和肿瘤坏死因子-α（TNF-α）浓度显著降低，IL-2和IFN-γ治疗前后的变化显著更大。综合这些数据表明，IFN-α与抗分枝杆菌疗法联合应用时可能有利于肺结核病情的转归。
