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Interferon is a complex family of natural proteins induced in response to various stimuli by the host. The gene regulation of interferon synthesis may explain the various effects which are observed during viral, malignant and angiogenic diseases.

Interferon types

Interferon type I (α, β, θ, ω ) is a family of products related to genes situated on chromosome 9. Their biological activity is very diverse: virus inhibition, reduced tumour proliferation, antigen modulation, immuno-modulation.

Interferon type II ( γ ) has other receptors and actions.

Antitumour activity

Interferon has been tested in many different malignant diseases for which some positive effects have been observed :

• Melanoma (increase of survival at high dosage),
  
• Kidney cancer (10 to 15% response rate),
  
• Myeloid chronic leukaemia (response rate in aproximatively 60% of chemoresistant forms),
  
• Kaposi's sarcoma associated with AIDS (with a lymphocyte CD4 level higher than 250/mm3),
  
• Hairy cell leukaemia (normalisation of biology).

It is difficult to explain by which mechanism an antitumour effect is observed among certain patients, since there are great heterogeneities between patients themselves, solid tumours generally being less sensitive than ‘liquid’ tumours.

Among the different mechanisms implied in the tumour response, the following are mentioned in literature:

• A direct effect on cell proliferation (modulation of STAT signaling),
  
• Enzyme induction, particularly for neopterin,
  
• Cell differentiation with modifications in reactions to growth factors,
  
• Modulation of antigen activities of the tumour surface antigen (particularly for melanoma),
  
• Stimulation of Natural Killer Cells, macrophages and dendritic cells,
  
• Stimulation of specific cytotoxic T lymphocytes,
  
• Stimulation of the production of antitumour immunoglobulins,
  
• Activation of other cytokines around the tumour cells (particularly Interleukine 2 or IL-2).

Toxic effects

Acute effects

General acute effects are the most commonly observed manifestations: fever, shuddering, headache, muscle pains, nausea, vomiting, diarrhoea.

Prolonged hyperthermia, tachycardia, anaemia, moderate neutropenia and/or rashes are also frequently observed.

More rarely observed: rhabdomyolysis, sub-acute liver necrosis.

Chronic side effects

Certain of which are almost constant: anorexia, dysgueusia (perversion of taste), fatigue, depression.

Others are rare: weight loss, alopecia, hypothyroidism.

And others very exceptional: nephrotic syndrome.

Recombining interferon

For oncology (at least in France) we can use Interferon α2-b with the following indications

• Hairy cell leukaemia,
  
• Asymptomatic evolutive Kaposi's sarcoma,
  
• Chronic Myelogenic leukaemia (in chronic phase),
  
• T Cell cutaneous lymphoma,
  
• Follicular Non Hodgkin's Lymphoma,
  
• Kidney cancer (advanced disease),
  
• Malignant melanoma (stage II),
  
• Multiple myeloma (after efficient chemotherapy).

The usual dosage varies according the pathology from 1 Million Units to 18 Millions Units, and is generally administered intramuscularly.