Bax HI, Freeman AF, Ding L, Hsu AP, Marciano B, Kristosturyan E, Jancel T, Spalding C, Pechacek J, Olivier KN, Barnhart LA, Boris L, Frein C, Claypool RJ, Anderson V, Zerbe CS, Holland SM, Sampaio EP. Interferon alpha treatment of patients with impaired interferon gamma signaling.
J Clin Immunol 2013;
33:991-1001. [PMID:
23512243 PMCID:
PMC4136390 DOI:
10.1007/s10875-013-9882-5]
[Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 02/27/2013] [Indexed: 11/27/2022]
Abstract
Patients with deficiency in the interferon gamma receptor (IFN-γR) are unable to respond properly to IFN-γ and develop severe infections with nontuberculous mycobacteria (NTM). IFN-γ and IFN-α are known to signal through STAT1 and activate many downstream effector genes in common. Therefore, we added IFN-α for treatment of patients with disseminated mycobacterial disease in an effort to complement their IFN-γ signaling defect. We treated four patients with IFN-γR deficiency with adjunctive IFN-α therapy in addition to best available antimicrobial therapy, with or without IFN-γ, depending on the defect. During IFN-α treatment, ex vivo induction of IFN target genes was detected. In addition, IFN-α driven gene expression in patients' cells and mycobacteria induced cytokine response were observed in vitro. Clinical responses varied in these patients. IFN-α therapy was associated with either improvement or stabilization of disease. In no case was disease exacerbated. In patients with profoundly impaired IFN-γ signaling who have refractory infections, IFN-α may have adjunctive anti-mycobacterial effects.
Collapse