It is hazardous to treat HIV patients with interferon-alpha

Interferon-alpha produces significant decreases in HIV load

A randomized, controlled clinical trial was started in the pre-HAART era to compare the efficacy of zidovudine (AZT) and interferon-alpha (IFN-alpha) either alone or in combination to reduce HIV viremia, maintain CD4(+) cell count, and decrease time to AIDS progression and death. The purpose of the current study was to compare the effects of AZT and IFN on HIV load using modern technology. One hundred and eighty patients with CD4(+) counts above 500 cells/mm(3) were randomized to receive AZT alone, IFN-alpha alone, or AZT and IFN-alpha in combination. CD4(+) cell count and HIV load at baseline and at the last follow-up visit were compared, and time to AIDS or death was calculated by treatment group. At a mean follow-up of 45 weeks, the mean change in log HIV RNA was -0.06 for the AZT alone group, -0.47 for the AZT plus IFN-alpha group (P = 0.01 versus AZT group), and -0.35 for the IFN-alpha alone group (P = 0.02 versus AZT group). There was no significant difference among groups in change in total CD4(+) count or in time to AIDS or death. Since treatment with IFN-alpha produces significant decreases in HIV load, additional studies of IFN-alpha as part of a combination regimen are warranted.

Biochip as a potential platform of serological interferon α2b antibody assay

The formation of antibodies against cytokines may play a major role in the generation of the immune response and may affect treatment protocols with recombinant cytokines. Interferon (IFN) is one of the effective therapeutic agents with anti-viral and anti-tumor specific effects. The appearance of IFN antibodies in patients may limit the natural and the therapeutic effect by IFNs. In contrast to conventional ELISA techniques, we here report a simple biochip methodology that enables identification of antibodies against cytokines and peptides. The method takes advantage of a functionalized self-assembled monolayer modified by N-hydroxysuccinimide (NHS). To validate this surface, four human proteins: IFNalpha2b, leptin, growth hormone and human IgG, with molecular sizes ranging between 14 and 150 kDa, were used. A number of other parameters for protein assay conditions by array technology were evaluated concomitantly. Finally, 56 serum samples from patients treated with recombinant human IFNalpha2b were simultaneously tested on single chip. In these patients, 16.1% (9 of 56 cases) were positive for IFNalpha2b antibodies. All results were confirmed in an ELISA, specific for the identification of IFNalpha specific antibodies in human samples. The potential application of this protein biochip can be amplified rapidly and reliably to test not only IFNalpha2b, but also other cytokine specific antibodies. The clinical relevance of such assays for investigations in autoimmune disorders is expected.

Autoimmune aspects of cytokine and anticytokine therapies

Cytokines and anticytokines are used increasingly in the treatment of immune, autoimmune, inflammatory, infectious, and malignant disorders. Commonly used treatments include the anti-tumor necrosis factor agents interferon alpha, interferon beta, interferon gamma, and interleukin 2. Several autoimmune phenomena have been reported in patients treated with these substances. This review summarizes the published data on the autoimmune manifestations associated with cytokine and anticytokine therapies, as well as describes possible mechanisms of these phenomena.

A theory of cellular-function pathology: further development of Virchow's theory of cellular pathology

A new theory of pathology is introduced. The human cell is an organism in itself. It fulfills both cell-oriented and organism-oriented functions. Impairment of either one of these functions may lead to disease. This means that a structural lesion of a cell is not a sole and necessary cause of the beginning of disease. When a cell-oriented function is impaired the cell suffers, but the overt symptoms at the organ-organism level might be absent for a very long time. This is how a chronic asymptomatic disease starts. Measures of prophylaxis, diagnosis, and treatment should be centered upon maintenance and restoration of a balance between the cell-oriented and organism-oriented cellular functions.