Interferon alfa

Interferon alfa
Drug class
Names
Pronunciationin"' ter feer' on[1]
Other namesHuIFN-alpha-Le
Clinical data
UsesCancers, viral infections[1]
Side effectsFever, headache, joint pains, tiredness, hair loss, depression, shortness of breath, low white blood cells[2]
Common typesInterferon alfa-2a (Roferon-A)[1]
Interferon alfa-2b (Intron A)[2]
Interferon alfa-n3 (Alferon N)[2]
Peginterferon alfa-2a (Pegasys)[3]
Peginterferon alfa-2b (PegIntron, others)
External links
Drugs.comMonograph

Interferon alfa is a group of medications used to treat a number of cancers and viral infections.[1] Cancers it is used for include kidney, melanoma, multiple myeloma, leukemia, Kaposi's sarcoma, and non-Hodgkin's lymphoma.[4] Types of infections it is used for include hepatitis B and hepatitis C.[1] It is typically given by injection under the skin.[4]

Common side effects include fever, headache, joint pains, tiredness, hair loss, depression, shortness of breath, and low white blood cells.[2] Other side effects may include liver problems and pancreatitis.[1][2] It is a cytokine normally produced by the immune system.[1] There are a number of types including interferon alfa-2a, interferon alfa-2b, and interferon alfa-n3.[1][2] These may be pegylated (peginterferon alfa-2a and alfa-2b) to extend their duration of effect.[1]

Interferon alfa was approved for medical use in the United States in the 1980s for cancer and the 1990s for hepatitis B and C.[1] The pegylated version became available in 2000.[1] Interferon alfa-2a is no longer made.[5] In the United Kingdom peginterferon alfa-2a is commercially available.[3]

Composition

Interferon alfa contains a mixture of several proteins, all with structural, serological, and functional properties typical for natural interferon alpha (IFN-α). The major subtypes identified are IFN-α1, IFN-α2, IFN-α8, IFN-α10, IFN-α14 and IFN-α21. Of these, IFN-α2 and IFN-α14 are glycosylated. The IFN-α content is expressed in International Units per milliliter, and the drug product is formulated in isotonic phosphate buffer solution at pH = 7.2, and supplemented with human albumin at 1.5 mg/ml. The albumin used is a medicinal product approved in several countries, and is indicated for subcutaneous injection therapy.

Pharmacology

IFN-α8 enhances the proliferation of human B cells, as well as being able to activate NK cells. The subtypes α10 and α2, along with α8, are the most efficient and powerful NK cell activators. Subtypes α21 and α2 enhance the expression of IFN-gamma-inducible protein-10 (IP-10) in dendritic cells. Activated dendritic cells initiate immune responses and induce the expression of IP-10, a chemokine which promotes a Th1 inflammatory response.

IFN-α1 causes increased HLA-II expression, and can directly inhibit tumor cell growth in vitro. However, it is a poor activator of NK cells, has relatively little antiviral activity, does not induce B cell proliferation, and does not enhance HLA-I or tumor antigen expression. Despite its apparent inactivity, it is still used clinically in the treatment of metastatic renal cell carcinoma, with a reported lower toxicity than the recombinant IFN-α2. Overall, IFN-α has a general inflammatory action which skews the immune response towards a Th1 profile.

Subtype α2 increases the expression of HLA-I molecules, which correlates with IFN-α-mediated activation of memory CD8 cells and increased cytolytic action against virally infected cells and tumor cells (via cytotoxic CD8 cells).

Name

Although the pharmaceutical product is often simply called "interferon alpha" or "IFN-α" like its endogenous counterpart, the product's International nonproprietary name (INN) is interferon alfa (the spelling of 'alfa' with 'f' reflects INN naming conventions).

References

  1. 1 2 3 4 5 6 7 8 9 10 11 "Alpha Interferon". LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases. 2012. Archived from the original on 23 October 2021. Retrieved 27 November 2021.
  2. 1 2 3 4 5 6 "Interferon Alfa Monograph for Professionals". Drugs.com. Archived from the original on 1 September 2015. Retrieved 27 November 2021.
  3. 1 2 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 664. ISBN 978-0857114105.
  4. 1 2 "Interferon alfa | Cancer information | Cancer Research UK". www.cancerresearchuk.org. Archived from the original on 2021-10-17. Retrieved 2021-10-17.
  5. ↑ "Roferon-A, Interferon alfa-2a recombinant, injectable solution, 1mL". National Museum of American History. Archived from the original on 26 October 2016. Retrieved 27 November 2021.
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