Interferon-gamma and granulocyte-macrophage colony stimulating factor therapy in three patients with pulmonary aspergillosis.
An immune response mediated by type 2 cytokines is thought to contribute to the development and unfavorable outcome of aspergillosis. Adjuvant therapy with interferon-gamma (IFN-gamma) and granulocyte-macrophage colony stimulating factor (GM-CSF) was added to antifungal treatment in three nonneutropenic patients (one HIV-positive and two HIV-negative patients) with culture proven aspergillosis refractory to classical antifungal therapy. Clinical improvement was observed concomitantly with an increase in peripheral blood leukocyte proliferation and type 1 cytokines production. Our findings suggest an association between the improvement in type 1 cytokine production observed during IFN-gamma and GM-CSF administration and a better control of Aspergillus infection in patients with progressive disease despite adequate antifungal therapy.
Bandera
A
A
Division of Infectious Diseases, Dept. of Internal Medicine, San Gerardo Hospital, University of Milan-Bicocca, Via Solferino 16, 20052, Monza (Milan), Italy. a.bandera@hsgerardo.org
Trabattoni
D
D
Ferrario
G
G
Cesari
M
M
Franzetti
F
F
Clerici
M
M
Gori
A
A
D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016207:Cytokines / Q000276:immunology; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007371:Interferon-gamma / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D011859:Radiography
D000276:Adjuvants, Immunologic; D016207:Cytokines; D007371:Interferon-gamma; D016178:Granulocyte-Macrophage Colony-Stimulating Factor