Design of efficacy trials of cytokines in combination with antifungal drugs.
Resolution of invasive fungal infections is often dependent on recovery from an immunocompromised state, which indicates that host defense mechanisms are extremely important in the clearance of fungal pathogens. Immunotherapy aimed at enhancement of host defense mechanisms may improve clinical outcome of invasive mycoses. The design of trials of immunotherapy against fungal pathogens requires profound knowledge of the host defense mechanisms that are involved in invasive fungal infections. Prospective phase II studies with recombinant granulocyte colony-stimulating factor and interferon-gamma have been done. Recombinant interferon-gamma is a candidate for phase III trials of adjunctive immunotherapy for cryptococcal meningitis, invasive aspergillosis, and candidemia, but the proper design of future trials will be crucial to establish whether immunotherapy is of clinical value in the treatment of invasive fungal infections.
Kullberg
Bart Jan
BJ
Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. b.kullberg@aig.umcn.nl
Oude Lashof
Astrid M L
AM
Netea
Mihai G
MG
D000935:Antifungal Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007167:Immunotherapy; D009181:Mycoses / Q000517:prevention & control* / Q000628:therapy; D011315:Preventive Medicine; D012107:Research Design
D000935:Antifungal Agents; D016207:Cytokines