Exogenous Interferon-γ Immunotherapy for Invasive Fungal Infections in Kidney Transplant Patients

被引:78
作者
Armstrong-James, D. [1 ,5 ]
Teo, I. A. [1 ,5 ]
Shrivastava, S. [2 ,5 ]
Petrou, M. A. [3 ,5 ]
Taube, D. [4 ,5 ]
Dorling, A. [2 ,4 ,5 ]
Shaunak, S. [1 ,5 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Dept Infect Dis & Immun, Fac Med, London, England
[2] Univ London Imperial Coll Sci Technol & Med, Fac Med, Dept Immunol, London, England
[3] Univ London Imperial Coll Sci Technol & Med, Fac Med, Dept Med Mycol, London, England
[4] Univ London Imperial Coll Sci Technol & Med, Fac Med, W London Renal & Transplant Ctr, London, England
[5] Imperial Healthcare NHS Trust London, London, England
关键词
Interferon-gamma (IFN-gamma) immunotherapy; invasive fungal infections; kidney transplantation; HEMATOPOIETIC STEM-CELL; SOLID-ORGAN; IFN-GAMMA; CYCLOSPORINE-A; HOST-DEFENSE; RISK-FACTORS; RECIPIENTS; RESPONSES; THERAPY; DISEASE;
D O I
10.1111/j.1600-6143.2010.03094.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The incidence of invasive fungal infections (IFIs) in nonneutropenic solid organ transplant patients is increasing. We report our clinical experience with the use of interferon-gamma (IFN-gamma) immunotherapy in seven renal transplant patients who developed life threatening, disseminated IFIs refractory to conventional antifungal drug therapy. The infections were all microbiologically and histologically proven. The rapid cure of these disseminated infections with exogenous IFN-gamma injections was not associated with impaired kidney allograft function despite the use of liposomal amphotericin B in all cases. No clinical toxicity from the IFN-gamma immunotherapy was seen and no IFI relapsed during long-term follow-up. Our experience is both uncontrolled and in patients with unpredictable fungal infection-related outcomes. However, compared to standard approaches, the accelerated cure of life threatening, disseminated IFIs with 6 weeks of combination antifungal drug therapy and IFN-gamma immunotherapy saved lives, retained allograft function and led to substantial cost savings in this small patient group.
引用
收藏
页码:1796 / 1803
页数:8
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