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首页> 外文期刊>The Indian journal of tuberculosis >Immunotherapy for non-responders among patients of spinal tuberculosis
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Immunotherapy for non-responders among patients of spinal tuberculosis

机译：脊髓结核患者的非响应者免疫疗法

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Background: Combined chemo- and immunotherapy are the major advancement in the treatment of tuberculosis. Immunotherapy supposedly increases cure rate while reducing the duration of treatment and tissue damage. Non-responders are those patients of tuberculosis who do not respond to anti-tubercular therapy (ATT) in the desired manner despite the mycobacteria showing sensitivity to the given drugs. The role of immunotherapy in the treatment of this particular subset of patients has been investigated scarcely. Methods: The present study included a retrospective review of prospectively collected clinico-radiological data of 14 non-responder patients who were taking ATT for spinal tuberculosis for a mean duration of 10.3 months. An immunotherapeutic regime comprising of single intramuscular injection of vitamin D 600,000 IU, 3 days course of oral albendazole 200 mg daily, salmonella vaccine 0.5 ml intramuscular and influenza vaccine 0.5 ml intramuscular were added to ATT. The vaccines and the course of oral albendazole were repeated after a month. Results: Before immunotherapy, seven patients were partially dependent while other seven were completely dependent on others for activities of daily living. All except one patient after treatment became independent till last follow-up (p value <0.01). Post immunotherapy, ATT was continued for mean duration of 4.9 months with mean follow-up of 22.4 months. All patients showed good clinical response within 2-6 weeks after the initiation of immunotherapy. Conclusions: The crux to success of the immunotherapy regime is its potential to restore the existing Thl Th2 imbalance and to provide substitute to the anergic and dysfunctional immune cells.
机译：背景：联合化学和免疫疗法是治疗结核病的主要进步。免疫疗法认为，治愈率增加，同时降低治疗持续时间和组织损伤。尽管分枝杆菌表现出对给定药物的敏感性，但否应对结核病患者的结核病患者不响应抗结核治疗（ATT）。免疫疗法在治疗这种特定患者患者子集中的作用已经几乎已经研究过。方法：本研究包括对预期收集的14名非响应者患者的临床放射数据进行回顾性审查，该患者正在服用脊髓结核病的平均持续时间为10.3个月。包含单肌内注射维生素D 600,000 IU的免疫治疗制度，每天3天胰岛素疫苗200毫克，加入0.5ml肌肉疫苗0.5ml肌肉疫苗0.5ml肌肉疫苗。一个月后重复疫苗和口腔albendazole的过程。结果：在免疫疗法之前，7名患者部分依赖，而其他七名患者完全依赖于其他人的活动。除了治疗后的一名患者外，所有人都独立于最后一次随访（P值<0.01）。后免疫疗法，持续时间持续4.9个月的平均持续时间，平均随访22.4个月。所有患者在疗法开始后2-6周内均显示出良好的临床反应。结论：免疫治疗制度的成功症是其恢复现有Th2不平衡的潜力，并提供替代活障碍和功能障碍免疫细胞。

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