Author/Editor		Černelč, Peter
Title		Pomen citokinov za zdravljenje
Translated title		The use of cytokines in therapy
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 37, št. Suppl 5
Publication year		1998
Volume		str. 47-52
Language		slo
Abstract		Cytokines that regulate the differentiation and maturation of hemopoietic stem cells are called hemopoietic growth factors. Currently, erthyropoietin, G-CSF, GM-CSF and interferon alpha are used in clinical practice. Thanks to the development of recombinant DNA technology over the past 10 years, cytokines have begun to be produced in adequate quantities and are now available at an affordable cost. Erythropoietin is used in patients with anemia associated with chronic renal failure, in cancer patients and for stimulation of erythropoiesis during autologous transfusion. Recombinant human GM-CSF and G-CSF are administered as prophylaxis to patients with severe forms of neutropenia following cytotoxic chemotherapy and autologous stem cell transplantation, as well as to patients with sever neutropenia and sepsis. G-CSF is commonly used to stimulate stem cells before harvesting them for autologous transplantation. In addition to bone marrow transplantation, the use of interferon alpha is the most effective therapy in patients with chronic stages of chronic myeloid leukemia and chronic hepatitisa B and C. The introduction of cytokines in treatment has markedly changed the course of some some illnesses, but it has also reduced the risk of complications, and to some extent lowered the cost of treatment. The use of erythropoietin has replaced frequent blood transfusions, particularly in patients with chronic renal failure. CSF has decreased the rate of sepsis following cytotoxic chemotherapy, reduced the time of antibiotic therapy and hospitalisation, and facilitated harvesting of stem cells from the peripheral blood.
Summary		Citokine, ki uravnavajo delitev in zorenje krvotvornih matičnih celic, imenujemo rastni dejavniki hempoeze. Danes uporabljamo pri zdravljenju eritropoetin, granulocitne kolonije spodbujajoči faktor (G-CSF), granulocitno makrofagne kolonije spodbujajoči faktor (GM-CSF) in interferona alfa. Klinično uporabo citokinov je omogočila šele rekombinantna DNA proizvodnja v zadnjih 10 letih. Le tako jih lahko proizvedemo v zadostni količini za sprejemljivo ceno. Eritropoetin uporabljamo za zdravljenje anemije pri kronični odpovedi ledvic in pri bolnikih z neoplazmami ter za vzpodbuditev eritropoeze med odvzemi krvi za avtologno transfuzijo. Rekombinantna humana GM-CSF in G-CSF dajemo preventivno pri bolnikih s primarno hudo nevtropenijo ter za skrajšanje nevtropenije po citostatičnem zdravljenju in po presaditvi krvotvornih matičnih celic ter pri bolnikih s hudo nevtropenijo in sepso. G-CSF pa običajno dajemo za vzpodbuditev izplavljanja krvotvornih matičnih celic v kri pred zbiranjem za avtologno presaditev krvotvornih matičnic celic. Interferon alfa je najuspešnejše zdravilo, poleg presaditve kostnega mozga za zdravljenje kroničnega obdobja kronične mieloične levkemije in kroničnega hepatitisa B in C. Uporaba citokinov je pri nekaterih boleznih znatno spremenila napoved poteka bolezni, zmanjŠala možnost zapletov in do neke mere zmanjšala stroške zdralvjenja. Eritropoetin je nadomestil pogoste transfuzije krvi, predvsem pri bolnikih s kronično ledvično odpovedjo. CSF je zmanjšal verjetnost septičnih okužb po citostatičnem zdralvjenju, skrajšal dajanje antibiotikov in bivanje v bolnišnici ter omogočil odvzem krvotvornih matičnih celic iz periferne krvi.
Descriptors		CYTOKINES ERYTHROPOIETIN, RECOMBINANT COLONY-STIMULATING FACTORS, RECOMBINANT INTERFERON ALFA, RECOMBINANT