Subcutaneously administered interferon-gamma for the treatment of multidrug-resistant pulmonary tuberculosis.
OBJECTIVE
We evaluated the clinical and laboratory effects of subcutaneously administered interferon-gamma (IFN-gamma) in the treatment of chronic and advanced multidrug-resistant tuberculosis (MDR-TB).


METHODS
Eight patients with sputum smear and culture persistently positive MDR-TB were subcutaneously administered 2 million international units of recombinant human IFN-gamma three times a week for 24 weeks (72 doses total) between December 2002 and May 2003. Subjects also received a customized drug regimen containing second- and third-line antituberculosis agents based upon drug susceptibility testing and previous treatment history.


RESULTS
Body weight remained stable or slightly decreased in all subjects during the study period, and none displayed radiographic improvement on serial chest computed tomography scanning. Sputum smears and cultures remained positive for all patients, and there was no increase in the mean time to yield a positive culture (from 16.5+/-6.4 to 11.8+/-4.9 days). There was no enhancement of cell-mediated immune responses in terms of production of IFN-gamma or IL-10, or of composition of lymphocytes among peripheral blood mononuclear cells. In four patients, therapy was discontinued because of adverse reactions.


CONCLUSIONS
In patients with chronic and advanced MDR-TB, subcutaneous IFN-gamma treatment did not result in improvement in clinical, radiologic, microbiologic, or immunologic parameters.
Park
Seung-Kyu
SK
Department of Chest Surgery and the Clinical Research Center, National Masan Tuberculosis Hospital, Masan, and Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea.
Cho
Sungae
S
Lee
In-Hee
IH
Jeon
Doo-Soo
DS
Hong
Sung-Hee
SH
Smego
Raymond A
RA
Cho
Sang-Nae
SN
D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007371:Interferon-gamma / Q000008:administration & dosage* / Q000009:adverse effects / Q000096:biosynthesis / Q000276:immunology; D016753:Interleukin-10 / Q000096:biosynthesis; D008213:Lymphocyte Activation; D008297:Male; D011994:Recombinant Proteins; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000276:immunology / Q000382:microbiology / Q000628:therapy*
D011994:Recombinant Proteins; D016753:Interleukin-10; D007371:Interferon-gamma