[Do the interferons have an antifibrotic action? The internist's point of view]

The antifibrotic action of interferon alpha on the liver is now established in hepatitis C (cf. article by T. Poynard). Numerous in vitro experimental evidences may lead people into believing in the efficacy of interferon gamma in patients with mucous membrane and pulmonary fibrosis.

A randomized study has confirmed the efficacy of interferon gamma in the idiopathic pulmonary fibrosis, probably by an anti TGF beta action. Several open studies have shown the efficacy of interferon gamma in patients with post-radiation cutaneous fibrosis (Chernobyl survivors, sequelae of radiotherapy for cancer). In systemic sclerosis, several teams have shown that interferon gamma reduced collagen synthesis by sclerodermic fibroblasts in vitro. Four open studies have also confirmed the efficacy of interferon gamma in systemic sclerosis. In our experience concerning 20 patients with diffuse systemic sclerosis, the five years survival with long term therapy was 85% and we observed an improvement in the cutaneous suppleness in 40% of these cases. There was no serious side effect.

These encouraging results need to be confirmed by large randomized studies in pulmonary fibrosis and systemic sclerosis. Other indications should be assessed, particularly extra-cutaneous radiation sequelae and in systemic fibrosis (retroperitoneal, mediastinal and cervical).