The Safety and the Tolerability of Ultra Low Dose Interleukin-2 in Healthy Volunteers
Interleukin 2 (IL-2, aldesleukin) was discovered as a T cell growth factor more than 30
years ago. IL-2 was the first human cytokine used therapeutically. IL-2 induces antigen
specific T cells, and two important lymphocyte subsets: regulatory T cells (T-regs) and
natural killer cells (NK) cells. T-regs have a critical role in self-tolerance and
pathogenesis of autoimmune disease or graft versus host disease (GVHD), and they have been
extensively studied in solid tumors, hematologic malignancies, viral hepatitis, and HIV
infections. NK cells have a unique role in bridging innate and adaptive immunity. NK cells
facilitate hematopoietic stem cell (HSC) engraftment reduce GVHD and increase
graft-versus-leukemia (GVL) effects. NK cells have important roles on pathogenesis of
malignancies, autoimmune disease and AIDS. Conventional dose IL-2 treatment promotes marked
expansion of regulatory T cells, and NK cells but is associated with significant side
effects. However, much lower doses of interleukin-2 (0.5- 1MIU/m2/day) which lack
significant side effects, also induce expansion of T regs and NK cells. These observations
suggest that ultra low dose IL-2 would be safe and appropriate to give to hematopoietic stem
cell donors. The quality of the transplant would be improved because the higher dose of
T-regs would reduce the risk of GVHD while the higher NK cells would augment the GVL effect.
The aim of this study is to evaluate the safety and the tolerability of ultra low dose IL-2
in healthy volunteer for preferential expansion of T-regs and NK cells with a view to
extending ultra low dose IL-2 administration to stem cell donors. We anticipate that this
study will provide valuable information on the biology of IL-2 on the human immunome
applicable to various human disease conditions, including cancer, immunodeficiency disease,
autoimmune disease, and hematopoietic stem cell transplantation. The proposed IL-2 dose is
2-3 logs lower than the manufacturer's recommended dose. We therefore expect that the dose
used in this protocol will be well tolerated. Nevertheless, because there is little
information on the tolerability and safety of IL-2 at these ultra low doses, we have
structured this study as a safety protocol with stopping rules for unacceptable side
effects. This is important because we hope to use the safety data generated to justify a
future protocol giving ultra low dose IL-2 to stem cell donors.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Safety and tolerability of ultra low dose IL-2
4 weeks
Yes
Sawa Ito, M.D.
Principal Investigator
National Heart, Lung, and Blood Institute (NHLBI)
United States: Federal Government
110268
NCT01445561
September 2011
Name | Location |
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National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda, Maryland 20892 |