Clinical Efficacy of and Immunologic Alterations Caused by Interferon g Therapy for Alveolar Echinococcosis

Jenne, Lars; Kilwinski, Jochen; Radloff, Paul; Flick, Wiltrud; Kern, Peter

doi:10.1086/516316

Cited by 38 publications

(28 citation statements)

References 12 publications

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“…Two case reports documented the clinical efficacy of IFN-c-treatment. One patient suffering from severe side-effects caused by ABZ-therapy was treated with IFN-c during a 3-day period once a month, and this treatment prevented disease progression but did not alter the Th2-dominated immune response against this parasite (Jenne et al 1998). Another patient whose lesions were growing, despite mebendazole therapy, was treated with a combination of IFN-c and mebendazole, which halted the progression of disease as revealed in a 1-year follow-up period (Schmid et al 1995).…”

Section: Alveolar Echinococcosis (Ae)mentioning

confidence: 99%

Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis

et al. 2007

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Echinococcus granulosus and Echinococcus multilocularis are cestode parasites, of which the metacestode (larval) stages cause the diseases cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Albendazole and mebendazole are presently used for chemotherapeutical treatment. However, these benzimidazoles do not appear to be parasiticidal in vivo against AE. In addition, failures in drug treatments as well as the occurrence of side-effects have been reported. New drugs are needed to cure AE and CE, which are considered to be neglected diseases. Strategies currently being implemented to identify novel chemotherapeutical treatment options include (i) conventional primary in vitro testing of broad-spectrum anti-infective drugs, either in parallel with, or followed by, animal experimentation ; (ii) studies of drugs which interfere with the proliferation of cancer cells and of Echinococcus metacestodes ; (iii) exploitation of the similarities between the parasite and mammalian signalling machineries, with a special focus on targeting specific signalling receptors ; (iv) in silico approaches, employing the current Echinococcus genomic database information to search for suitable targets for compounds with known modes of action. In the present article, we review the efforts toward obtaining better anti-parasitic compounds which have been undertaken to improve chemotherapeutical treatment of echinococcosis, and summarize the achievements in the field of host-parasite interactions which may also lead to new immuno-therapeutical options.

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Section: Alveolar Echinococcosis (Ae)mentioning

confidence: 99%

Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis

et al. 2007

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“…It also inhibited IL-6 and IL-13 antigen-induced secretions in spleen cell cultures. Jenne et al (1998) reported a case of a 61 year old patient with Echinococus multilocularis infection of the lungs, liver, pericardium, bones and brain, which relapsed after 19 years of antiparasitic chemotherapy. This patient received 16 cycles of recombinant IFN-gamma; in total 250 µg monthly for 16 months.…”

Section: Discussionmentioning

confidence: 99%

Regression of alveolar echinococcosis after chronic viral hepatitis C treatment with pegylated interferon alpha 2a

Dražilová¹,

Kinčeková

Beňa³

et al. 2012

Helminthologia

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We present a case of 53 years old patient with transplanted kidney, chronic hepatitis C and alveolar echinococcosis who was treated with pegylated interferon α which resulted in regression and calcification of Echinococcus multilocularis loculi. Patient had been diagnosed with chronic hepatitis C two years after kidney transplantation. Hepatitis was left untreated because of immunosuppressive treatment and satisfactory graft function. Nine years after transplantation the patient was diagnosed with alveolar echinococcosis and treated with mebendazole 2 × 200 mg daily for 6 months. Cessation of temporary treatment resulted in echinococcosis progression with appearance of secondary loculi and a small ascites after which mebendazole was restarted. Ten years after transplantation, kidney graft failure occurred and the patient was started on hemodialysis in conjunction with pegylated-interferon alpha 2a for treatment of chronic viral hepatitis C. Complete early viral response was observed 3 months after therapy initiation while a follow-up CT scan after 4 months did not document any changes in the number or size of E. multilocularis loculi. A completed course of antiviral therapy resulted in sustained viral response while a subsequent second follow-up CT scan 6 months after cessation of antiviral therapy documented regression and calcification of main E. multilocularis loculi along with resolution of secondary loculi and ascites.

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“…IFN-gamma is the component part of the Th1 answer (together with interleukin-2 induced by interleukin-12), in the dominance of the Th1 response over the Th2 response reduction of echinococcal loci in the liver was noticed ( Vuitton & Gottstein, 2010). The IFN treatment prevents the echinococcal lesions growth in animal as well as human model (Liance et al, 1998;Jenne et al, 1998). Anti-parasitic treatment leads to IFN-gamma level increase ( Dvorožňáková et al, 2004).…”

Section: A 1bmentioning

confidence: 99%

Alveolar echinococcosis in patient after cadaveric kidney transplantation

Dražilová¹,

Kinčeková

Beňa³

et al. 2011

Helminthologia

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Abstract52-years old man years following the kidney transplantation from deceased donor was admitted to the hospital with fever and progressive abdominal pain. The patient was diagnosed with chronic hepatitis C seven years before admission. Graft function in posttransplant period was stable and optimal, the patient was treated with standard maintenance immunosupresive protocol (cyclosporine A, mycophenolate mofetil and low-dose prednison), metylprednisolon bolus therapy (1 g/m2 body surface area), was administered two months prior to admission due to creeping creatinine (suspection of acute rejection was not confirmed by biopsy). Empiric antibiotic treatment due to febrile status was ineffective. Abdominal ultrasound and computer tomography (CT) scan revealed three tumorous lesions in the liver, radical surgical intervention was not executable. Histological examination of the tissue from the lesions demostrated alveolar echinococcosis, serology for Echinoccocus multilocularis was positive. Long-term treatment by mebendazol 200 mg twice daily led to disappearance of the clinical symptoms, but after the therapy cessasion patient was again hospitalized with fever and progression of cystic lesions in CT scan. Following the mebendazol therapy reinstalation the clinical course of echinococcosis was improved and remained stable, transplant kidney failure occurred due to progression of interstitial fibrosis/tubular atrophy and chronic haemodialysis was initiated one year later.

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Clinical Efficacy of and Immunologic Alterations Caused by Interferon g Therapy for Alveolar Echinococcosis

Cited by 38 publications

References 12 publications

Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis

Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis

Regression of alveolar echinococcosis after chronic viral hepatitis C treatment with pegylated interferon alpha 2a

Alveolar echinococcosis in patient after cadaveric kidney transplantation

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