Clinical aspects

The major clinical use of IL-2 to date has involved tumor immunology. The potential for IL-2 as a cancer treatment is based on activation of cells which are cytotoxic for the tumor, and some success has been obtained with renal cell carcinoma and metastatic melanoma. However the use of II.-2 is limited by various side-effects. To circumvent these difficulties lymphokine-activated killer (LAK) cells as well as tumor-infiltrating lymphocytes (TILs) have been tested after in vitro activation by IL-2. Local delivery of IL-2 to the tumor site and genetic modification of the tumor cells by the IL-2 gene are currently under clinical trial.

Coupled to toxin, IL-2 can be used as an immunosuppressive agent. IL-2 fragments coupled to Pseudo-monas exotoxin (IL-2-PE40) or diphtheria toxin (II.-2-DAB486) have been studied. They inhibit graft rejection in animals and were found to have beneficial effects on rheumatoid arthritis. Drugs which limit the production of IL-2 (cyclosporine and FK506) are classically used during graft transplantation in humans.

IL-2 has been used in AIDS (acquired immune deficiency syndrome) patients as an immunostimula-tory agent able to limit the effects of CD4 depletion. After IL-2 injection and under some clinical conditions, IL-2 treatment is followed by an increase of the CD4 count without affecting the viral load.

See also: Interleukin 2 receptor; Interleukin 4; Interleukin 7 and its receptor; Interleukin 9 and its receptor; Interleukin 15 and its receptor; Tumors, immune response to.

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