Interferon-alpha: A new promissing therapeutic alternative in corticosteroid-resistant asthma

We describe the case of a 38-year-old fe male patient who experienced recur ring episodes of worsening of her respiratory situation associated with mar ked blood eosinophilia despite high-dose systemic glucocorticoid therapy. P eripheral blood T cells produced interleukin (IL)-5 and showed a normal exp ression of T cell-associated surface molecules. Immunohistochemical analysi s of bone marrow biopsies showed an increased expression of the eosinophil hematopoietins IL-3, IL-5, and GM-CSF during eosinophilic episodes. Taken t ogether, the eosinophilia observed in this patient was most likely due to o verexpression of hematopoietins leading to an increased generation of eosin ophils. In contrast to treatments with high-dose corticosteroids, cyclospor in A, or the leukotrien-receptor-antagonist zafirlucast, systemic interfero n-alpha therapy (interferon-alpha 2a, Roferon) resulted in a marked improve ment of the clinical situation as well as an effective and sustained normal ization of the eosinophil count. Although the exact mechanism of action of interferon-alpha remains unclear, some immunological tests indicate the pos sibility of increased steroid sensitivity. Interferon-alpha appears to be a n effective and safe therapy in such cases of severe asthma.