title: Two cases illustrating successful adjunctive interferon-γ immunotherapy in refractory disseminated coccidioidomycosis.
abstract: Protective immunity and host resistance to coccidioidomycosis require a robust cell-mediated immunity with adequate production of Th1 cytokines including interleukin-12, and IFN-γ and appropriate regulation and coordinated functionality of Th1/Th2 responses and IL-12/IFN-γ cytokine axes. IFN-γ augments the anti-fungal activity of effector immune cells against a variety of fungi. Numerous animal models have demonstrated the potential efficacy of adjunctive IFN-γ in treatment of invasive mycoses. Yet, despite these promising data, a paucity of literature documents efficacious adjunctive IFN-γ administration in refractory coccidioidomycosis. We present two cases of refractory disease occurring at our institution who responded to adjunctive IFN-γ.
authors.affiliation: Infectious Disease Naval Hospital, Naval Medical Center San Diego, 34800 Bob Wilson Drive, Ste. 5, San Diego, CA 92134-1005, USA. christopher.duplessis@med.navy.mil
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Duplessis
authors.forename: Drake
authors.initials: D
authors.lastname: Tilley
authors.forename: Mary
authors.initials: M
authors.lastname: Bavaro
authors.forename: Braden
authors.initials: B
authors.lastname: Hale
authors.forename: Steven M
authors.initials: SM
authors.lastname: Holland
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage*; D002140:California; D003045:Coccidioides / Q000187:drug effects / Q000302:isolation & purification; D003047:Coccidioidomycosis / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007371:Interferon-gamma / Q000008:administration & dosage*; D018664:Interleukin-12 / Q000378:metabolism; D008297:Male; D008889:Military Personnel; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D018664:Interleukin-12; D007371:Interferon-gamma