Interferon-A 2a administration in chronic anergic brucellosis.

Two cases with chronic anergic brucellosis are described. Both patients suffered repeated disease relapses and responded poorly to conventional treatment. The immunologic research revealed that both patients were anergic to brucella antigens and immunocompromised. In an effort to restore patients' defective immune responses, we administered Interferon-A 2a during a six month treatment period as follows: a) loading dose- 3MU SC 3 days/week for an 8 week trial, followed by, b) maintenance period- 3MU SC three times/week. Our results showed that IFN administration induced clinical remission in both patients by the end of the 4th month of treatment. Additionally, Coombs' agglutination titers decreased gradually, the leucocyte migration index and the skin tests developed "energy" to antigens and the monocyte macrophage function tests were restored to normal. We concluded that IFN treatment can be beneficial in chronic anergic brucellosis by restoring defective immune responses, promoting therefore a sufficient inflammatory response against brucella infection.

Recombinant a2 interferon (a-IFN) with chemo-hormonal therapy in patients with hepatocellular carcinoma (HCC).

Recent studies on HCC treatment reveal a tendency to use combined immuno-chemo-therapy. Additionally, new agents have been suggested in this field. We therefore studied 7 patients with proven inoperable HCC who were treated in accordance with the following protocol, and 5 untreated patients used as controls. Therapeutic trial: 1) 1FNa (Roferon): 6 MU x 7 days consecutively every 3 weeks, 2) Adriamycin (doxorubicin): 60 mg/m2 i. v. once every 3 weeks (500 mg total dose), 3) Tamoxifen: 10 mg p.o. twice daily continuously 4) Desferrioxamine (DFO): 500 mg i.m. daily x 7 days consecutively every 3 weeks, 5) ascorbic acid: 300 mg p.o. daily 1 hour after DFO administration x 7 days consecutively every 3 weeks. Follow-up studies were performed monthly and comprised clinical, biochemical, radiological and immunological (T-cell subsets, NK cells, monocyte-macrophage function, IL-2r expression, HLA-DR expression) parameters. Compared with the control group, the treated group had a longer survival rate (p < 0.001), increased tumor regression and less progressive disease. Immunologically, the treated patients with the maintenance of a sufficient immune status were associated with a prolonged survival rate. No serious side effects of the regimen were observed. In conclusion, IFNa combined with chemohormonal therapy appears to be beneficial in HCC patients. In addition, a prolonged survival rate might correlate with the maintenance of an adequate immune status in the patients.

In vivo effect of omeprazole on HLA-DR expression and the monocyte-macrophage function in patients with duodenal ulcer disease.

It is not known if omeprazole possesses any action on immune system. Therefore, we examined the effect of omeprazole on parameters of cellular immunity [T-cell subsets-CD3+, CD4+, CD(8+)- and HLA-DR expression on peripheral blood lymphocytes (PBLs)] and on function of peripheral blood monocyte-macrophages (PBMMs) [random migration (RM), directed migration (DM), phagocytosis index (P-I) and HLA-DR expression] in 13 duodenal ulcer patients before and during 3-mo omeprazole treatment. The number of T-cell subsets varied at pretreatment values (p > 0.05), whereas the percentage of HLA-DR positive PBLs increased significantly after 3-mo therapy (p < 0.001). On the other hand, all studied parameters concerning PBMMs (RM, DM, P-I and HLA-DR expression) increased significantly after 3-mo therapy (p < 0.001, p < 0.001, p < 0.003, p < 0.001, respectively vs. baseline values). In conclusion, omeprazole exerts an immunopotentiating effect on functions of PBMMs and may also influence T-cell function. These effects can be considered as an advantage of omeprazole in long-term treated patients with peptic ulcer disease.