Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis
BACKGROUND:. We report the case of a patient with aplastic anemia and pancytopenia on immune-suppressive therapy who developed invasive pulmonary infection with mucormycosis and was treated with immune adjuvant therapy. CASE SUMMARY:. Given the patient’s profound lymphopenia and progressive invasive...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-10-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000990 |
| _version_ | 1797646878911758336 |
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| author | Zachary D. Crees, MD Dilan A. Patel, MD Alexandra Dram, BS Miriam Kim, MD Michael D. Bern, MD, PhD Allison R. Eberly, PhD Kristan Augustin, PharmD Richard S. Hotchkiss, MD John F. DiPersio, MD, PhD |
| author_facet | Zachary D. Crees, MD Dilan A. Patel, MD Alexandra Dram, BS Miriam Kim, MD Michael D. Bern, MD, PhD Allison R. Eberly, PhD Kristan Augustin, PharmD Richard S. Hotchkiss, MD John F. DiPersio, MD, PhD |
| author_sort | Zachary D. Crees, MD |
| collection | DOAJ |
| description | BACKGROUND:. We report the case of a patient with aplastic anemia and pancytopenia on immune-suppressive therapy who developed invasive pulmonary infection with mucormycosis and was treated with immune adjuvant therapy.
CASE SUMMARY:. Given the patient’s profound lymphopenia and progressive invasive mucor despite dual antifungal drug therapy, interleukin (IL)-7, a cytokine that induces lymphocyte activation and proliferation, was instituted and resulted in normalization of absolute lymphocyte counts and was temporally associated with clearance of fungal pathogens and resolution of clinical symptoms.
CONCLUSION:. Patients with life-threatening fungal infections are frequently immune suppressed and immune adjuvant therapies should be considered in patients who are not responding to antifungal drugs and source control. Well-designed, double-blind, placebo-controlled trials are needed to advance the field. Although a number of immune adjuvants may be beneficial in fungal sepsis, IL-7 is a particularly attractive immune adjuvant because of its broad immunologic effects on key immunologic pathways that mediate enhanced antifungal immune system activity. |
| first_indexed | 2024-03-11T15:08:11Z |
| format | Article |
| id | doaj.art-bdf577804d9e406e8669458440656c6c |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-03-11T15:08:11Z |
| publishDate | 2023-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-bdf577804d9e406e8669458440656c6c2023-10-30T03:41:30ZengWolters KluwerCritical Care Explorations2639-80282023-10-01510e099010.1097/CCE.0000000000000990202310000-00016Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and MucormycosisZachary D. Crees, MD0Dilan A. Patel, MD1Alexandra Dram, BS2Miriam Kim, MD3Michael D. Bern, MD, PhD4Allison R. Eberly, PhD5Kristan Augustin, PharmD6Richard S. Hotchkiss, MD7John F. DiPersio, MD, PhD81 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.2 Department of Anesthesiology and Critical Care Medicine, Washington University School of Medicine, St Louis, MO.1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.3 Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO.4 Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO.1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.1 Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.BACKGROUND:. We report the case of a patient with aplastic anemia and pancytopenia on immune-suppressive therapy who developed invasive pulmonary infection with mucormycosis and was treated with immune adjuvant therapy. CASE SUMMARY:. Given the patient’s profound lymphopenia and progressive invasive mucor despite dual antifungal drug therapy, interleukin (IL)-7, a cytokine that induces lymphocyte activation and proliferation, was instituted and resulted in normalization of absolute lymphocyte counts and was temporally associated with clearance of fungal pathogens and resolution of clinical symptoms. CONCLUSION:. Patients with life-threatening fungal infections are frequently immune suppressed and immune adjuvant therapies should be considered in patients who are not responding to antifungal drugs and source control. Well-designed, double-blind, placebo-controlled trials are needed to advance the field. Although a number of immune adjuvants may be beneficial in fungal sepsis, IL-7 is a particularly attractive immune adjuvant because of its broad immunologic effects on key immunologic pathways that mediate enhanced antifungal immune system activity.http://journals.lww.com/10.1097/CCE.0000000000000990 |
| spellingShingle | Zachary D. Crees, MD Dilan A. Patel, MD Alexandra Dram, BS Miriam Kim, MD Michael D. Bern, MD, PhD Allison R. Eberly, PhD Kristan Augustin, PharmD Richard S. Hotchkiss, MD John F. DiPersio, MD, PhD Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis Critical Care Explorations |
| title | Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis |
| title_full | Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis |
| title_fullStr | Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis |
| title_full_unstemmed | Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis |
| title_short | Immune Adjuvant Therapy With Interleukin-7 in a Lymphopenic Patient With Aplastic Anemia and Mucormycosis |
| title_sort | immune adjuvant therapy with interleukin 7 in a lymphopenic patient with aplastic anemia and mucormycosis |
| url | http://journals.lww.com/10.1097/CCE.0000000000000990 |
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