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NEUROLOGY 1987;37:1097
© 1987 American Academy of Neurology

Treatment of multiple sclerosis with gamma interferon

Exacerbations associated with activation of the immune system

Hillel S. Panitch, MD, Robert L. Hirsch, PhD, John Schindler, PhD and Kenneth P. Johnson, MD

Department of Neurology (Drs. Panitch, Hirsch, and Johnson), Maryland Center for Multiple Sclerosis, University of Maryland; the Veterans Administration Medical Center (Drs. Panitch and Johnson), Baltimore, MD; and the Biogen Research Corporation (Dr. Schindler), Cambridge, MA.

We treated 18 clinically definite relapsing-remitting MS patients with recombinant gamma interferon in a pilot study designed to evaluate toxicity and dosage. Patients received low (1 µg), intermediate (30 µg), or high (1,000 µg) doses of interferon by intravenous infusion twice a week for 4 weeks. Serum levels of gamma interferon were proportional to dose and no interferon was detected in CSF. Seven of the 18 patients had exacerbations during treatment, a significant increase compared with the prestudy exacerbation rate (p < 0.01). Exacerbations occurred in all three dosage groups and were not precipitated by fever or other dose-dependent side effects. There were significant increases in circulating monocytes bearing class II (HLA-DR) surface antigen, in the proliferative responses of peripheral blood leukocytes, and in natural killer cell activity. These results show that systemic administration of gamma interferon has pronounced effects on cellular immunity in MS and on disease activity within the CNS, suggesting that the attacks induced during treatment were immunologically mediated. Gamma interferon is unsuitable for use as a therapeutic agent in MS. Agents that specifically inhibit gamma interferon production or counteract its effects on immune cells should be investigated as candidates for experimental therapy.

Address correspondence and reprint requests to Dr. Panitch, Department of Neurology, University of Maryland, 22 South Greene Street, Baltimore, MD 21201.

Supported by Biogen Research Corporation, National Institutes of Health Center Grant NS-20022, and the Veterans Adminiatration.

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received January 28, 1987. Accepted for publication in final form April 23, 1987.




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