Adjunctive interferon-γ immunotherapy in a pediatric case of Aspergillus terreus infection

Collection Location Koleksi E-book & E-Journal Perpustakaan Pusat Unila
Edition Vol. 37, Issue. 10
Call Number
ISBN/ISSN 1435-4373
Author(s) Assendorp, Eemke L...[et al.]
Subject(s) Biomedicine
Classification NONE
Series Title
GMD E-Journal
Language English
Publisher Springer
Publishing Year 2018
Publishing Place Switzerland
Abstract/Notes Abstract
Aspergillus terreus causes invasive aspergillosis (IA) in immunocompromised patients. Treatment is complicated by intrinsic
resistance to amphotericin B and thereby contributing to a high mortality. Therefore, we conducted in vitro studies to investigate
the effectivity of adjunctive recombinant interferon-γ immunotherapy. We describe a pediatric patient with A. terreus IA who
received adjunctive recombinant interferon-γ (rIFNγ) immunotherapy. In vitro studies were conducted to investigate the capacity
of rIFNγ to improve antifungal host defense in terms of fungal killing ability and the release of pro-inflammatory cytokines in
cells of the patient as well as healthy controls. An 8-year-old female pediatric patient with leukemia developed A. terreus IA. She
clinically deteriorated and had high serum galactomannan levels despite broad antifungal therapy. Therefore, adjunctive immune
stimulatory therapy with rIFNγ was initiated. After 3 weeks of treatment, galactomannan levels decreased and the patient
clinically showed improvement. Addition of rIFNγ boosted the capacity of monocytes of healthy volunteers to mount TNFα
and IL-1β cytokine responses to Escherichia coli LPS, and increased TNFα response to both A. terreus and Aspergillus
fumigatus. Monocytes isolated from the patient’s blood demonstrated a similar augmented cytokine induction in response to
rIFNγ. In addition, rIFNγ increased the capacity of monocytes from healthy volunteers as well as monocytes from the patient to
kill A. terreus spores. Adjuvant immunotherapy with rIFNγ might be a promising additional treatment strategy that could be used
to improve outcome in patients with refractory invasive A. terreus infections or other resistant invasive Aspergillus infections.
Keywords Aspergillus terreus . Interferon-γ . Immunotherapy . Invasive aspergillosis
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