Interleukin-2 is a cytokine that supports the immune system by increasing the production and count of CD4 cells to fight infections. It is used to treat certain types of cancer and chronic viral infections, but its use in HIV treatment is problematic. Interleukin-2 therapy comes with various side effects and is not suitable for everyone. It must be administered intravenously and is available as the generic drug Aldesleukin or under the brand name Proleukin.
Interleukin-2 is a cytokine, a specialized protein produced in the body by white blood cells called T cells, also known as CD4 cells. Like interleukin, it acts as an immune system signaling molecule that transmits information from cell to cell. Interleukin-2 synthesis is stimulated by the presence of an infection. Its mechanism of action is to support the immune system by acting as an immune modulator. This is accomplished by increasing the production and count of CD4 cells to fight the infection.
As you might expect, a low CD4 cell count can indicate the onset of the disease. Invading viral molecules, or antigens, attack and permeate these cells across their membranes. The antigens then multiply with the aim of replicating and spreading the virus to other cells. A healthy immune system responds by first detecting invading microbes through the antigen receptors that reside on the surface of lymphocytes. When antigens bind to receptor sites, the production and release of interleukin-2 is triggered. However, if immunity is impaired, this process can be inhibited.
In the United States, the Food and Drug Administration has approved the use of interleukin-2 for the treatment of certain types of cancer; such as melanoma, lymphoma and kidney cancer. Additionally, interleukin-2 therapy may be useful in the treatment of some chronic viral infections. However, its use in the treatment of human immunodeficiency virus (HIV) is problematic and not yet approved. This is mainly because, unless antiretroviral drugs are given as a control factor, interleukin-2 therapy can drive HIV viral replication up to six times the pre-treatment level.
Interleukin-2 must be administered intravenously as it is a protein that would otherwise be digested if taken orally. Most often, it’s given as injections under the skin, twice a day at five-day intervals. However, interleukin-2 is sometimes given by the bolus method, where the dose is given by continuous intravenous (IV) therapy over the course of a few hours.
Not everyone is a candidate for interleukin-2 therapy. For example, those taking immunosuppressant drugs, such as cortisone or prednisone, will likely not benefit from interleukin-2 therapy. Also, treatment with interleukin-2 can make some immune disorders, such as diabetes, worse. Other factors that may rule out interleukin-2 therapy for some individuals is a decrease in neutrophil production and thyroid function.
Interleukin-2 therapy also comes with various side effects, which is why patients receiving high doses are usually hospitalized and monitored in hospital. Common side effects include nausea, fatigue, confusion, depression, irritability, and insomnia. Capillary leak syndrome can occur at injection sites, which can promote fluid retention, swelling, weight gain, and low blood pressure. High-dose interleukin-2 therapy can also cause tachycardia (fast heartbeat) and affect the way your liver, lungs, or kidneys work.
Interleukin-2 is available as the generic drug Aldesleukin or under the brand name Proleukin. Eligibility for interleukin-2 therapy is determined by a healthcare professional after a review of all existing medical conditions and current treatments. If qualified, regular checkups are needed to monitor and manage any side effects that may develop.
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