Am. J. Respir. Crit. Care Med., Vol 152, No. 3, 09 1995, 1094-1096.
Aerosolized interferon gamma for Mycobacterium avium-complex lung disease
G Chatte, G Panteix, M Perrin-Fayolle and Y Pacheco
Service de pneumologie, Centre Hospitalier Lyon-Sud, Pierre-Benite, France.
It has recently been shown that human alveolar macrophages can be
selectively activated without systemic effect by the use of aerosolized
interferon-gamma (IFN gamma), a cytokine that enhances macrophage oxidative
and antimicrobial activity. We report the case of a 38-yr-old man negative
for human immunodeficiency virus (HIV), with silicosis and advanced
cavitary lung disease due to Mycobacterium avium intracellulare (MAI), who
failed to improve despite 3 yr of continuous medical therapy with three or
more drugs. He received three courses of aerosolized IFN gamma (500
micrograms 3 d per week for 5 wk in two courses and 200 micrograms 3 d a
week for 5 wk after a short single trial of subcutaneous IFN gamma). The
numbers of MAI decreased in the sputum during therapy, but cultures of the
organism remained positive at the same level for the first two treatment
periods. The patients sputum became AFB smear negative and the number of
colonies decreased significantly after the third course of IFN gamma
therapy. Cessation of IFN gamma was associated with a rapid increase in the
numbers of MAI in the sputum. Aerosolized IFN gamma can be considered as an
adjuvant to conventional drug therapy, with a good tolerance, in cases of
lung disease caused by resistant MAI.
