Immune reactions and long-term therapy with human leukocyte interferon

Interferons and osteosarcoma

In 1970, we initiated studies at the Karolinska hospital to find out whether biologically meaningful doses of interferon (IFN) alpha preparations could be administered systemically to patients with viral and tumour diseases without causing unacceptable side effects. Antiviral and antitumour efficiency was demonstrated. Only a limited number of patients were injected due to shortage of high dose IFN preparations. Osteosarcoma patients participated in these early attempts. Due to clinical observations on one patient and due to lack of meaningful systemic standard treatment for osteosarcoma at the time, we decided to continue to give adjuvant IFN treatment to a consecutive series of osteosarcoma patients attending our hospital . We were encouraged by the preliminary follow up results of the series and continued to use this therapeutic principle up to 1990. The clinical results achieved are briefly summarized in this mini-review as are the results obtained in simultaneously ongoing model experiments in vitro and in vivo. A randomized large scale ongoing trial, involving the use of adjuvant IFN treatment of osteosarcoma patients, has been initiated by the European and American osteosarcoma study group 35 years after the first osteosarcoma patient received IFN. The trial is briefly outlined in this article.

Behavioral assessment of patients treated with alpha-interferon

To document behavioral effects of interferon (IFN) with daily consecutive assessments we developed an easily administered procedure for bedside testing. It included assessment of mental control and affective behavior, and a self-assessment questionnaire. The method was evaluated in 9 lung cancer patients before and during the treatment with alpha-IFN and the results were supplemented with those obtained by a neuropsychological test battery of one of the patients. The latter tests covered memory, visuoperceptual, visuoconstructional, speech, language, intellectual and psychomotor functions, reading, writing, and calculation. The bedside method was capable of revealing the essential effects of IFN on human behavior, i.e. irritability, slowing of behavior, dyscoordination, and motor perseveration. Consequently, the bedside testing method is recommended for frequently repeated clinical assessments of aberrant behavior of patients treated with IFN, while neuropsychological test batteries serve better for testing situations requiring more detailed and quantified data of localization value.

A sensitive radioimmunoassay for detection of antibodies to recombinant human interferon-alpha A

A radioimmunoassay (RIA) for the detection of antibodies to recombinant human leukocyte interferon A (rHuIFN-alpha A) in human serum has been developed and validated against the standard antiviral neutralization bioassay (ANB). The assay measures the binding of 125I-labeled rHuIFN-alpha A to immunoglobulins in serum. Aliquots of patients' sera are incubated with 125I-rHuIFN-alpha A and the complexes formed between antibodies in the sera and the 125I-rHuIFN-alpha A are precipitated with goat anti-human IgG serum. The radioactivity in the immune precipitate is a measure of the quantity of antibody (if present) in the serum. The sensitivity of this RIA is 5 ng of IgG/ml of serum.

High titer of interferon (IFN)-neutralizing antibody in a patient with glioblastoma treated with IFN-alpha. Case report

In a patient with glioblastoma treated with interferon (IFN-alpha) for a long period of time, a high titer of IFN-neutralizing antibody was detected in the serum during and after IFN therapy. Computerized tomography findings and neurological symptoms in this patient were unchanged during IFN therapy. General malaise, fever, anorexia, nausea, and decrease of leukocytes, platelets, erythrocytes, hemoglobin, and hematocrit were recognized transiently as side effects of IFN administration. These side effects were not serious and resolved spontaneously without discontinuation of therapy. The appearance of IFN-neutralizing antibody is clinically important because the antibody probably neutralizes the effect of systemically administered IFN before it reaches the site of action.

Interferon--present and future prospects

The interferons are a group of proteins that have inspired a new era of investigation into biological modification. The interferons are now divided into subgroups characterized by chemical means and correspond to different biological responses which can be observed in terms of the inducer used, and the timing of the response. Identified originally as antiviral agents when homologous cell systems were treated prior to infection, new studies have extended these observations to place the interferons in a central role as a strong force in the regulation of immunologic responses. A marriage of interferonology and cell immunology is enlarging both our understanding of the action of these proteins and our ability to follow the course of an illness and eventually to control its outcome . Genetic engineering has provided a way to process quantities of interferon and provided the molecular sequence of all three classes of IFN including a model of the active site for IFN-alpha. The offshot of the technology developed to study the intracellular processes after interferon treatment have already led to increased sensitivity to detect virally treated diseases. Both the variety of the interferon inducers and the scope of parasites in which it can exert its influence provide a frontier of biological investigation which has at the root of its nature the very secret of life. In addition to cellular phenomena, the positive effects on tumor-bearing organisms and the ill effects on infant animals highlight the potential power of the interferons.

Antibodies to human leucocyte interferons in cancer patients

During the course of clinical investigation of partly purified human leucocyte interferon (IFN) prepared at the Finnish Red Cross (PIF), neutralising IgG antibodies to human leucocyte IFN were detected in the sera of 3 patients with cancer. In 2 of these patients, the antibodies were detected in serum before treatment with PIF. In the third patient antibodies developed during the course of treatment. Antibody titres against six recombinant human leucocyte IFN sub-types and one recombinant hybrid human leucocyte IFN were different in the 3 patients.

Interferon therapy in neoplastic diseases

Three types of interferon preparation (alpha, beta and gamma) have been used in the treatment of tumours in vivo. At the time of writing no information is available on IFN-gamma treatment of tumour patients. Treatments with IFN-alpha and IFN-beta have been undertaken at many clinical centres. Both types of preparation can exert side effects. Both types have also been able to cause regression of certain tumours in individual patients. At our hospital, IFN-alpha has been given to tumour patients over the last decade. Antitumour effects have been registered on patients with juvenile laryngeal papillomatosis, Hodgkin's disease, myelomatosis, ovarian carcinoma, hypernephroma and glioblastoma. Further study is needed on how therapy with IFN should best be undertaken and also how such treatment compares with other treatments of various tumour diseases. IFN therapy should also be combined with other such treatments.

A radioimmunoassay of human leukocyte interferon using protein A-containing Staphylococcus aureus

We report the establishment of a radioimmune assay for human alpha-interferon using highly purified alpha-interferon labeled with iodine-125, a purified rabbit immunoglobulin directed against human interferon and the Cowan strain of Staphylococcus aureus. Radiolabeling conditions used do not change the antigenicity of interferon molecules. The regression of counts bound upon log. dose was found to be linear down to 10 units/ml of alpha-interferon (6-7 X10-12 M). This assay was specific for alpha-interferons derived from human peripheral blood leukocytes and from a continuous line of lymphoblastoid cells. No cross-reaction was found with either human beta-interferon or murine interferon. Neither human serum nor plasma interfered with the assay. Correlation between biological assay and radioimmune assay was found to be significant.