難治性結核に対するBRM療法の試み A PUTATIVE IMMUNOTHERAPY WITH BIOLOGICAL RESPONSE MODIFIERS (BRM) AGAINST INTRACTABLE PULMONARY TUBERCULOSIS

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著者

    • 斎藤 厚 SAITO Atsushi
    • 琉球大学医学部第一内科 First Department of Internal Meicine, Faculty of Medicine, University of the Ryukyus

抄録

The problem of tuberculosis is emerging again with increase in the population of aged people and immunocompromised patients in Japan. It has been well documented that cell?mediated immunity play a central role in host resistance to infection with <I>Mycobacterium tuberculosis.</I> Many recent studies have provided evidences suggesting that the Th1-Th2cytokine balance may determine the outcome of some diseases: predominant production of Th 1 cytokines may prevent the occurrence of infectious diseases caused by intracellularly growing pathogens and Th2 cytokines may be involved in the exacerbation of allergic diseases. On the other hand, IL-12 plays an essential role in the differentiation of Th 1cells from naive T cells, and IL-18 potentiates this effect although it does not show such effect by itself. In previous investigations using gene?disrupted mice, the essential roles for IFN-γ, IL-12 and IL-18 have been demonstrated. There are several host factors which dete rmines the outcome of mycobacterial infection. Among them, steroid treatment and AIDS are important factors. In this lecture, I addressed the effect of these pathological conditions on Th1-Th2 cytokine balance and outcome of mycobacterial infection using murine models. In both conditions, the exacerbated infection was well correlated with the reduced production of IFN-γ Furthermore, I also talked about the relationship between other host factors and balance in the production of Th1 and Th2 cytokines. Using a murine model of fatal infection with <I>M. tuberculosis, </I> we demonstrated the therapeutic effect of Th1-type cytokines against this infection and suggested that immunotherapy with these cytokines may be clinically effective in the intractable infection. We tried a combined therapy with anti-tuberculous agents and IFN-γin intractable pulmonary tuberculosis caused by multidrug-resistant pathogen in a patient with insulin dependent diabetes mellitus. Although no report showing the clinical use of IL-12 in infectious diseases has been seen, clinical trials already commenced for the therapy of malignant neoplastic diseases. It may not be in far future that this cytokine is clinically used for the treatment of infectious diseases. IL-18 has not yet been under the clinical trials.

収録刊行物

  • 結核

    結核 76(12), 741-747, 2001-12-15

    JAPANESE SOCIETY FOR TUBERCULOSIS

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各種コード

  • NII論文ID(NAID)
    10008113148
  • NII書誌ID(NCID)
    AN00073442
  • 本文言語コード
    JPN
  • 資料種別
    REV
  • ISSN
    00229776
  • NDL 記事登録ID
    026781109
  • NDL 請求記号
    Z19-133
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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