Abstract
An immune response mediated by type 2 cytokines is thought to contribute to the development and unfavorable outcome of aspergillosis. Adjuvant therapy with interferon-gamma (IFN-gamma) and granulocyte-macrophage colony stimulating factor (GM-CSF) was added to antifungal treatment in three nonneutropenic patients (one HIV-positive and two HIV-negative patients) with culture proven aspergillosis refractory to classical antifungal therapy. Clinical improvement was observed concomitantly with an increase in peripheral blood leukocyte proliferation and type 1 cytokines production. Our findings suggest an association between the improvement in type 1 cytokine production observed during IFN-gamma and GM-CSF administration and a better control of Aspergillus infection in patients with progressive disease despite adequate antifungal therapy.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adjuvants, Immunologic / adverse effects
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Adjuvants, Immunologic / pharmacology
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Adjuvants, Immunologic / therapeutic use*
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Adult
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Aged
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Aspergillosis / complications
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Aspergillosis / diagnostic imaging
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Aspergillosis / drug therapy*
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Cytokines / immunology
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Female
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Gene Expression Regulation / drug effects
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Granulocyte-Macrophage Colony-Stimulating Factor / adverse effects
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Granulocyte-Macrophage Colony-Stimulating Factor / immunology
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Granulocyte-Macrophage Colony-Stimulating Factor / pharmacology
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Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
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HIV Infections / complications
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Humans
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Interferon-gamma / adverse effects
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Interferon-gamma / immunology
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Interferon-gamma / pharmacology
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Interferon-gamma / therapeutic use*
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Lung Diseases, Fungal / complications
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Lung Diseases, Fungal / diagnostic imaging
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Lung Diseases, Fungal / drug therapy*
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Male
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Radiography
Substances
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Adjuvants, Immunologic
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Cytokines
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Interferon-gamma
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Granulocyte-Macrophage Colony-Stimulating Factor