rhuIL-2 adjunctive therapy in multidrug resistant tuberculosis: A comparison of two treatment regimens and placebo
Date
1997
Authors
Johnson B.J.
Bekker L.-G.
Rickman R.
Brown S.
Lesser M.
Ress S.
Willcox P.
Steyn L.
Kaplan G.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Setting: Low-dose recombinant human interleukin 2 (rhuIL-2) adjunctive immunotherapy in multidrug resistant tuberculosis (MDR-TB) patients. Objective: Evaluation of the effects of daily versus pulse-administered rhuIL-2 compared to placebo. Design: 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. Results: 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. Conclusion: Daily low dose rhuIL-2 adjunctive treatment stimulates immune activation and may enhance the antimicrobial response in MDR-TB.
Description
Keywords
cd56 antigen, clofazimine, ethambutol, ethionamide, interleukin 2 receptor, isoniazid, kanamycin, ofloxacin, pyrazinamide, recombinant interleukin 2, rifabutin, rifampicin, streptomycin, terizidone, thioacetazone, adult, article, bacterial count, clinical article, clinical trial, controlled study, drug efficacy, female, human, immunostimulation, intradermal drug administration, male, multidrug resistance, priority journal, sputum culture, thorax radiography, treatment outcome, tuberculosis, Adult, Antigens, CD56, Antitubercular Agents, Chemotherapy, Adjuvant, Drug Administration Schedule, Female, Humans, Immunophenotyping, Interleukin-2, Lung, Male, Middle Aged, Receptors, Interleukin-2, Recombinant Proteins, Sputum, Tuberculosis, Multidrug-Resistant
Citation
Tubercle and Lung Disease
78
3-4
78
3-4