rhuIL-2 adjunctive therapy in multidrug resistant tuberculosis: a comparison of two treatment regimens and placebo.
METHODS
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.


METHODS
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.


CONCLUSIONS
Daily low dose rhuIL-2 adjunctive treatment stimulates immune activation and may enhance the antimicrobial response in MDR-TB.
Laboratory of Cellular Psysiology and Immunology, Rockefeller University, New York, USA.
B J
BJ
Johnson
L G
LG
Bekker
R
R
Rickman
S
S
Brown
M
M
Lesser
S
S
Ress
P
P
Willcox
L
L
Steyn
G
G
Kaplan
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D019002:CD56 Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007376:Interleukin-2 / Q000008:administration & dosage* / Q000627:therapeutic use; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015375:Receptors, Interleukin-2 / Q000097:blood; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology
D000995:Antitubercular Agents; D019002:CD56 Antigen; D007376:Interleukin-2; D015375:Receptors, Interleukin-2; D011994:Recombinant Proteins