Adjunct oral immunotherapy in patients with re-treated, multidrug-resistant or HIV-coinfected TB

被引:5
作者
Arjanova, Olga V. [5 ]
Prihoda, Nathalia D. [5 ]
Yurchenko, Larisa V. [5 ]
Sololenko, Nina I. [5 ]
Frolov, Valery M. [1 ]
Tarakanovskaya, Marina G. [2 ]
Batdelger, Dendev [3 ]
Jirathitikal, Vichai [4 ]
Bouinbaiar, Aldar S.
机构
[1] Luhansk State Med Univ, Lugansk, Ukraine
[2] Ekomed LLC, Ulaanbaatar, Mongolia
[3] NRCID, Ulaanbaatar, Mongolia
[4] Immunitor Thailand Co LLC, Chachoengsao, Thailand
[5] Listchansk Reg TB Dispensary, Listchansk, Ukraine
关键词
DOT; extensively drug resistant; HIV-TB; immunomodulator; multidrug-resistant TB; Mycobacterium; therapeutic vaccination; OPEN-LABEL TRIAL; RECEIVING ANTITUBERCULOSIS THERAPY; INFECTED PATIENTS; PULMONARY TUBERCULOSIS; VACCINE; DZHERELO; EFFICACY; ASPIRIN; ADULTS;
D O I
10.2217/IMT.10.96
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
This Phase IIb, placebo-controlled study involved 55 TB patients treated with anti-TB therapy. They were divided into two groups, matched by age, gender, baseline bodyweight and clinical manifestations: one group (n = 27) received a once-daily V-5 Immunitor (V5) immunotherapy pill and the other (n = 28) received placebo. Only one (3.7%) and three (10.7%) subjects in V5 and placebo arms, respectively had first-diagnosed, drug-sensitive TB; the remaining patients had re-treated TB, multidrug-resistant TB or HIV-TB coinfection. After 1 month, 26 out of 27 patients (96.3%) became sputum smear negative in the V5 group (p < 0.0000001), whereas seven out of 28 (25%) in the placebo group had converted (p = 0.005). V5 contributed to the downregulation of TB-associated inflammation, as shown by normalization of high leukocyte counts, erythrocyte sedimentation rate and faster defervescence than controls. Patients in both arms experienced an increase in the levels of hemoglobin corresponding to 128.9 +/- 17.6 versus 133.1 +/- 14.7 g/I (p = 0.03) and 112.6 +/- 14 versus 117 +/- 11.7 g/I (p = 0.03) in V5 and placebo arms, respectively. In total, 19 out of 28 placebo patients (67.9%) gained, on average, 1.07 kg (59.1 +/- 10 vs 60.1 +/- 10.4 kg; p = 0.003). By contrast, all patients in the V5 group gained weight with mean 3.4 kg (59.7 +/- 8 vs 63.1 +/- 9 kg; p = 5.7E-007). Clinical symptoms improved among all patients in V5 arm, while 28.6% of patients on placebo reported satisfactory results (p = 0.007). No adverse or side effects attributable to V5 were seen at any time. Further studies are needed to gauge the extent of the benefits of V5 as safe and effective adjunct immunotherapy for TB.
引用
收藏
页码:181 / 191
页数:11
相关论文
共 47 条
[1]  
Arjanova OV, 2009, IMMUNOTHERAPY-UK, V1, P549, DOI [10.2217/IMT.09.25, 10.2217/imt.09.25]
[2]  
Arjanova OV, 2010, J VACCINES VACCINATI, V1, P103, DOI DOI 10.4172/2157-7560.1000103
[3]  
Arjanova OV, 2009, J ANTIVIR ANTIRETROV, V1, P86
[4]   Open-label trial of therapeutic immunization with oral V-5 Immunitor (V5) vaccine in patients with chronic hepatitis C [J].
Batdelger, Dendev ;
Dandii, Dorjiin ;
Jirathitikal, Vichai ;
Bourinbaiar, Aldar S. .
VACCINE, 2008, 26 (22) :2733-2737
[5]   Open label trial of therapeutic hepatitis B vaccine V-5 immunitor (V5) delivered by oral route [J].
Batdelger, Dendev ;
Dandii, Dorjiin ;
Jirathitikal, Vichai ;
Bourinbaiar, Aldar S. .
LETTERS IN DRUG DESIGN & DISCOVERY, 2007, 4 (08) :540-544
[6]   Clinical Experience with Therapeutic Vaccines Designed for Patients with Hepatitis [J].
Batdelger, Dendev ;
Dandii, Dorjiin ;
Dahgwahdorj, Yagaanbuyant ;
Erdenetsogt, Erdene ;
Oyunbileg, Janchivyn ;
Tsend, Navaansodov ;
Bayarmagnai, Bold ;
Jirathitikal, Vichai ;
Bourinbaiar, Aldar S. .
CURRENT PHARMACEUTICAL DESIGN, 2009, 15 (11) :1159-1171
[7]   Aspirin and ibuprofen enhance pyrazinamide treatment of murine tuberculosis [J].
Byrne, Sean T. ;
Denkin, Steven M. ;
Zhang, Ying .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2007, 59 (02) :313-316
[8]   Aspirin antagonism in isoniazid treatment of tuberculosis in mice [J].
Byrne, Sean T. ;
Denkin, Steven M. ;
Zhang, Ying .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2007, 51 (02) :794-795
[9]   Treatment and outcome analysis of 205 patients with multidrug-resistant tuberculosis [J].
Chan, ED ;
Laurel, V ;
Strand, MJ ;
Chan, JF ;
Huynh, MLN ;
Goble, M ;
Iseman, MD .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2004, 169 (10) :1103-1109
[10]   Advances in Immunotherapy for Tuberculosis Treatment [J].
Churchyard, Gavin J. ;
Kaplan, Gilla ;
Fallows, Dorothy ;
Wallis, Robert S. ;
Onyebujoh, Philip ;
Rook, Graham A. .
CLINICS IN CHEST MEDICINE, 2009, 30 (04) :769-+