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Aerosolized interferon gamma for Mycobacterium avium-complex lung disease
G Chatte1, G Panteix, M Perrin-Fayolle
1Service de pneumologie, Centre Hospitalier Lyon-Sud, Pierre-Benite, France.
American Journal of Respiratory and Critical Care Medicine
|September 1, 1995
Summary
Aerosolized interferon-gamma (IFN gamma) shows promise in treating resistant Mycobacterium avium intracellulare lung infections. This cytokine therapy, used alongside traditional drugs, improved patient outcomes and reduced bacterial load.
Area of Science:
- Pulmonology
- Immunology
- Infectious Diseases
Background:
- Human alveolar macrophages can be activated locally with aerosolized interferon-gamma (IFN gamma).
- IFN gamma enhances macrophage oxidative and antimicrobial activity.
- Mycobacterium avium intracellulare (MAI) causes advanced cavitary lung disease, often resistant to standard therapies.
Observation:
- A 38-year-old HIV-negative male with silicosis and advanced cavitary MAI lung disease showed no improvement with 3 years of multi-drug therapy.
- The patient received three courses of aerosolized IFN gamma.
- Sputum MAI initially decreased but cultures remained positive; AFB smears became negative and colony counts significantly dropped after the third IFN gamma course.
Findings:
- Aerosolized IFN gamma therapy led to a significant reduction in MAI bacterial load in sputum.
- Cessation of IFN gamma resulted in a rapid increase of MAI in sputum, indicating a sustained effect.
- The treatment was well-tolerated by the patient.
Implications:
- Aerosolized IFN gamma may serve as an effective adjuvant therapy for refractory lung infections caused by MAI.
- Local delivery of IFN gamma offers a targeted approach to enhance macrophage function in lung infections.
- This case highlights a potential new strategy for managing difficult-to-treat mycobacterial lung diseases.