Immunomodulatory treatment of Mycobacterium avium complex bacteremia in patients with AIDS by use of recombinant granulocyte-macrophage colony-stimulating factor.

TitleImmunomodulatory treatment of Mycobacterium avium complex bacteremia in patients with AIDS by use of recombinant granulocyte-macrophage colony-stimulating factor.
Publication TypeJournal Article
Year of Publication1998
AuthorsKemper CA, Bermudez LE, Deresinski SC
JournalThe Journal of infectious diseases
Volume177
Issue4
Pagination914-20
Date Published1998 Apr
ISSN0022-1899
KeywordsAdjuvants, Immunologic, Adult, AIDS-Related Opportunistic Infections, Anti-Bacterial Agents, Azithromycin, Bacteremia, Drug Therapy, Combination, Female, Granulocyte-Macrophage Colony-Stimulating Factor, Humans, Male, Microbial Sensitivity Tests, Monocytes, Mycobacterium avium Complex, Mycobacterium avium-intracellulare Infection, Superoxides
Abstract

Eight AIDS patients with Mycobacterium avium complex (MAC) bacteremia were randomized to receive azithromycin with or without granulocyte-macrophage colony-stimulating factor (GM-CSF) for 6 weeks to examine the effect of GM-CSF administration on clearance of mycobacteremia and on monocyte function. Superoxide anion production was significantly increased ex vivo in monocytes from patients receiving GM-CSF but not in those from patients receiving azithromycin alone. Relative to monocytes obtained from untreated healthy controls, median differences in viable intracellular MAC at 2, 4, and 6 weeks were -0.76, -0.94, and -0.47 log10 cfu/mL of lysate for cells from patients receiving GM-CSF versus -0.15, -0.11, and -0.19 log10 cfu/mL for cells from patients receiving azithromycin alone. Although no effect on mycobacteremia was detected, the administration of GM-CSF to AIDS patients with MAC bacteremia resulted in activation of their blood monocytes, as evidenced by increased superoxide anion production and enhanced mycobactericidal activity. GM-CSF deserves further investigation in the treatment of mycobacterial infections.

Alternate JournalJ. Infect. Dis.