J Korean Med Sci.  2004 Apr;19(2):167-171. 10.3346/jkms.2004.19.2.167.

Six-month Therapy with Aerosolized Interferon-gamma for Refractory Multidrug-Resistant Pulmonary Tuberculosis

• Koh WJ
• Kwon OJ
• Suh GY
• Chung MP
• Kim H
• Lee NY
• Kim TS
• Lee KS

• KMID: 1733472
• DOI: http://doi.org/10.3346/jkms.2004.19.2.167

Abstract

The aim of this study was to investigate the adjuvant effects of interferon-gamma (IFN-gamma) inhalation therapy for six months in the treatment of refractory multidrug-resistant pulmonary tuberculosis (MDR-TB). Aerosolized IFN-gamma was given to six MDRTB patients with persistent positive smears and cultures despite long-term medical treatment. The patients received aerosolized two million international units of IFNthree times a week for 6 months while they continued on identical antituberculous chemotherapy. Before IFN-gamma inhalation therapy, the patients received a median of 6.5 (range, 4 to 7) antituberculous drugs for median duration of 29 months (range,7 to 76). After IFN-gamma inhalation therapy, sputum smears remained persistently positive in all patients throughout the study period. Sputum cultures were transiently negative at the 4th month in two patients, but became positive again at the end of 6 months of IFN-gamma therapy. Five patients had radiological improvement including three patients who showed a decrease in the size of the cavitary lesions. Resectional surgery could be performed in one patient in whom substantial clinical and radiological improvement was noted after IFN-gamma inhalation therapy. These results suggest that IFN-gamma inhalation therapy may be effective for some cases of refractory MDR-TB who are otherwise not responding to conventional therapy.

Keyword

Tuberculosis, Pulmonary; Tuberculosis, Multidrug-Resistant; Interferon-gamma, Recom-binant; Administration, Inhalation; Aerosols

MeSH Terms

Administration, Inhalation
Adult
Antineoplastic Agents/*administration & dosage
Antitubercular Agents/therapeutic use
Drug Resistance, Bacterial
Drug Resistance, Multiple
Drug Therapy, Combination
Female
Human
Interferon Type II/*administration & dosage
Male
Middle Aged
Support, Non-U.S. Gov't
Tuberculosis, Pulmonary/*drug therapy/radiography

Figure

• 

  Fig. 1 27-yr-old male patient with multidrug-resistant tuberculosis. (A) Computed tomographic scan of the chest showed multiple cavities in the right upper lobe and small nodular infiltrations in the left upper lobe. (B) The extent of radiographic infiltrations of the left upper lobe increased despite 6 months of antituberculous chemotherapy. (C) After 6 months of IFN-γ inhalation therapy, computed tomographic scan showed reduction in the size of cavitary lesions in the right upper lobe and improvement of nodular infiltrates in the left upper lobe.

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