晚期癌症患者I期临床试验中IL-1 α和β对内分泌的影响

B D Curti, W J Urba, D L Longo, J E Janik, W H Sharfman, L L Miller, G Cizza, M Shimizu, J J Oppenheim, W G Alvord, J W Smith
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引用次数: 19

摘要

先前的灵长类动物和啮齿动物研究表明,白细胞介素-1 α (IL-1 α)引起垂体、肾上腺、甲状腺和性腺激素以及急性期反应物分泌的变化。肿瘤患者接受IL-1 α和β治疗后获得血浆样本,以记录动物模型提示的内分泌功能变化。连续组患者分别以0.01、0.03、0.1、0.3和1.0微克/千克的IL-1剂量治疗,每天静脉注射15分钟。IL-1 β按0.1微克/千克给予相同的途径和时间过程。第一次注射IL-1后,上午和下午皮质醇、生长激素(GH)和催乳素(PRL)出现统计学显著升高。治疗第6天,促甲状腺激素(TSH)和c反应蛋白(CRP)升高。男性患者睾酮水平明显下降。促卵泡激素(FSH)和黄体生成素(LH)变化较大,但多数患者均有所下降。皮质醇、GH、PRL、TSH、CRP、FSH、LH和睾酮的变化在治疗后消失,没有导致临床上明显的内分泌病变。大剂量IL-1 α和β可引起许多内分泌实验室参数的显著变化,并影响人体多种稳态内分泌功能的体内活动。
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Endocrine effects of IL-1 alpha and beta administered in a phase I trial to patients with advanced cancer.

Previous primate and rodent studies suggested that interleukin-1 alpha (IL-1 alpha) caused changes in the secretion of pituitary, adrenal, thyroid, and gonadal hormones, as well as acute-phase reactants. Plasma samples were obtained after IL-1 alpha and beta treatment in cancer patients to document the changes in endocrine function suggested by the animal models. Successive groups of patients were treated at IL-1 alpha doses of 0.01, 0.03, 0.1, 0.3, and 1.0 microgram/kg, given daily as a 15-min intravenous bolus. IL-1 beta was given at 0.1 microgram/kg by the same route and time course. After the first dose of IL-1, statistically significant elevations of a.m. and p.m. cortisol, growth hormone (GH), and prolactin (PRL) occurred. Thyroid-stimulating hormone (TSH) and C-reactive protein (CRP) were elevated by the sixth treatment day. Testosterone decreased significantly in male patients. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were more variable but decreased in most patients. The changes in cortisol, GH, PRL, TSH, CRP, FSH, LH, and testosterone resolved after treatment and did not result in clinically apparent endocrinopathies. Bolus doses of IL-1 alpha and beta cause significant changes in many endocrine laboratory parameters and influence the in vivo activities of multiple homeostatic endocrine functions in human beings.

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