Interferon-alpha affects the immune response in post-transplant lymphoproliferative disorder.
Post-transplant lymphoproliferative disorder (PTLD) is associated with Epstein-Barr virus (EBV) and characterized by fever, lymphadenopathy, and graft dysfunction. We describe the clinical course of an EBV seronegative 11-yr-old boy who underwent double lung transplantation and subsequently developed PTLD in the graft. A reduction in immunosuppression and the addition of acyclovir did not result in improvement. Treatment with interferon-alpha (IFN-alpha), however, led to dramatic clinical, radiographic, and histologic improvement. Semiquantitative measurements of cytokine mRNA in his bronchoalveolar lavage cells prior to therapy with IFN-alpha revealed high levels of IL-4 and IL-10 mRNA, which decreased significantly with treatment. We speculate that the beneficial effect of IFN-alpha in the treatment of PTLD is directly related to the inhibition of type 2 helper (Th2-like) T-cells.
Faro
A
A
Division of Pulmonology, Infectious Disease, and Cardiology, Children's Hospital of Pittsburgh, Pennsylvania, USA.
Kurland
G
G
Michaels
M G
MG
Dickman
P S
PS
Greally
P G
PG
Spichty
K J
KJ
Noyes
B B
BB
Boas
S R
SR
Fricker
F J
FJ
Armitage
J M
JM
Zeevi
A
A
D001992:Bronchoalveolar Lavage Fluid; D002648:Child; D016207:Cytokines / Q000032:analysis*; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000009:adverse effects / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*; D008297:Male; D011183:Postoperative Complications / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000187:drug effects / Q000502:physiology; D014181:Transplantation Immunology / Q000276:immunology
D016207:Cytokines; D016898:Interferon-alpha