Am. J. Respir. Crit. Care Med., Vol 153, No. 4, Apr 1996, 1442-1447.
Interferon-alpha affects the immune response in post-transplant lymphoproliferative disorder
A Faro, G Kurland, MG Michaels, PS Dickman, PG Greally, KJ Spichty, BB Noyes, SR Boas, FJ Fricker, JM Armitage and A Zeevi
Division of Pulmonology, Infectious Disease, and Cardiology, Children's Hospital of Pittsburgh, Pennsylvania, USA.
Post-transplant lymphoproliferative disorder (PTLD) is associated with
Epstein-Barr virus (EBV) and characterized by fever, lymphadenopathy, and
graft dysfunction. We describe the clinical course of an EBV seronegative
11-yr-old boy who underwent double lung transplantation and subsequently
developed PTLD in the graft. A reduction in immunosuppression and the
addition of acyclovir did not result in improvement. Treatment with
interferon-alpha (IFN-alpha), however, led to dramatic clinical,
radiographic, and histologic improvement. Semiquantitative measurements of
cytokine mRNA in his bronchoalveolar lavage cells prior to therapy with
IFN-alpha revealed high levels of IL- 4 and IL-10 mRNA, which decreased
significantly with treatment. We speculate that the beneficial effect of
IFN-alpha in the treatment of PTLD is directly related to the inhibition of
type 2 helper (Th2-like) T-cells.
