Interleukin clinical significance

A study found that a 4-week course of interleukin-2 (0.25 million units/m daily) by continuous infusion had no clinically significant effect on the pharmacokinetics of a 100-mg intravenous dose of zidovudine. Another study in 8 HIV-positive men given oral zidovudine 200 mg every 4 hours found similar results. No special precautions would seem necessary. 

Interleukin-11 is the first growth factor to gain FDA approval for treatment of thrombocytopenia. It is approved for the secondary prevention of thrombocytopenia in patients receiving cytotoxic chemotherapy for treatment of nonmyeloid cancers. Clinical trials show that it reduces the number of platelet transfusions required by patients who experienced severe thrombocytopenia after a previous cycle of chemotherapy. Although IL-11 has broad stimulatory effects on hematopoietic cell lineages in vitro, it does not appear to have significant effects on the leukopenia or neutropenia caused by myelosuppressive chemotherapy. Interleukin-11 is given by subcutaneous injection at a dose of 50 g/kg/d. It is started 6-24 hours after completion of chemotherapy and continued for 14-21 days or until the platelet count passes the nadir and rises to > 50,000 cells/ L. 

Alesci S, Martinez PE, Kelkar S, Bias 1, Ronsaville DS, Listwak SJ, Ayala AR, Licinio 1, Gold HK, Khng MA, Chrousos GP, Gold PW (2005) Major depression is associated with significant diurnal elevations in plasma interleukin-6 levels, a shift of its circadian rhythm, and loss of physiological complexity in its secretion Clinical implications. J Clin Endocrinol Metab 90 2522-2530. 

Finally, biological response modifiers should be mentioned. Immunostimulants, a concept predating this century, are making a modern-day comeback with intensive research of interferons, interleukin, and synthetic polynucleotides. Studies involving interleukin-2 described significant responses in patients with melanoma, colorectal, kidney, and lung cancers. This and other stimulant factors are now in clinical use (see Chapter 15). 

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