Zytokintherapie bei malignen Hauterkrankungen und insbesondere beim malignen Melanom

 

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Zusammenfassung

Zytokine sind hormonähnliche Glykoproteine mit para- oder autokriner Wirkung. Zytokine regulieren Immunreaktionen und Entzündungsvorgänge. Ihren Effekt üben Zytokine durch Bindung an spezifische Zellrezeptoren aus, welche eine Signalübertragung in die Zelle und schliesslich den biologischen Effekt bewirken. Die Zytokine können unterteilt werden in Interleukine, Interferone, colony-stimulating Factors, Tumornekrosefaktoren und transforming growth Factor β, wobei in der Dermatologie vor allem Interferon-α, -β, -γ, Interleukin-2, GM-CSF sowie Interleukin-12 zur Anwendung kommen. Nebenwirkungen einer Zytokintherapie bestehen meist aus grippalen Beschwerden, ausserdem kann es zu Leukopenien sowie Leberwerterhöhungen kommen. Die Nebenwirkungen lassen sich durch Paracetamol und Dosisanpassung meist gut angehen. Gewisse Zytokine wie z. B. Interferon-α sind für bestimmte dermatologische Erkrankungen bereits registriert, während andere noch in klinischen Studien erprobt werden. Dieser Artikel beschränkt sich auf die Anwendung bei malignen Hauterkrankungen, wo verbesserte Therapieoptionen dringend nötig wären.

Abstract

Cytokines are glycoproteins similar to hormones with a paracrine or autocrine effect. Cytokines regulate immune reactions and inflammatory processes. They bind to specific cell receptors which then activate a signalling cascade and in the end a biological effect. Cytokines can be divided into interleukins, interferons, colony-stimulating factors, tumor necrosis factors and transforming growth factor β. In dermatology, above all interferon-α, -β, -γ, interleukin-2, GM-CSF and interleukin-12 are used. Side effects of a cytokine therapy include flu-like symptoms, leukopenia and increase of liver enzymes. In most cases these side effects can easily be treated with paracetamol and dose reduction. Some cytokines such as interferon-α are already registered whereas others are applied in clinical trials. This article is limited to cytokine therapy of malignant skin tumors, where better treatment results are needed.

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Dr. M. Beyeler

Dermatologische Klinik · Universitätsspital Zürich

Gloriastraße 31 · 8091 Zürich · Schweiz

Email: mirjam.beyeler@usz.ch