- 學位論文
貓重組干擾素Omega於貓慢性齒齦口炎輔助治療之臨床效果評估
Clinical Application of Feline Recombinant Interferon Omega (ATRIron®) as an Additional Agent in Refractory Feline Chronic Gingivostomatitis
摘要
貓慢性齒齦口炎(Feline chronic gingivostomatitis)為一慢性消耗性且疼痛的口腔疾病，其致病病因及機轉尚未完全明瞭，但多數研究顯示貓慢性齒齦口炎為多因素所引起。治療方面，目前可分成內科及外科治療，外科治療需經由全面性口腔評估及齒科檢查後拔除異常牙齒及移除牙菌斑。經齒科拔牙治療後，部分貓隻之口腔黏膜發炎會消退、緩解；然而，經齒科治療後仍未改善之貓隻，稱之為復發型貓慢性齒齦口炎，需以內科藥物控制且大多數的貓隻需要終生服用藥物。內科治療為給予抗生素、止痛藥、干擾素、非固醇類消炎藥、類固醇或免疫抑制劑等，以類固醇最常使用。然而，長期使用類固醇治療可能誘發糖尿病等副作用。 1957 年發現干擾素至今，已有多種人類重組干擾素被應用於多種人類病毒性及腫瘤性疾病，人類重組干擾素也被使用於控制某些犬貓病毒性疾病，然而研究發現貓隻於治療過程中，因產生抗人類重組干擾素的中和抗體而影響藥物活性及降低藥效進而降低治療效果。因此，本研究目的為評估慢性齒齦口炎貓隻加入農業科技研究院動物科技研究所提供之貓重組干擾素⍵ (Feline recombinant interferon omega; ATRIron®)為輔助治療之治療成效評估。慢性齒齦口炎貓隻於治療前、治療後第 2、4 及 6 週回診時，以半定量評分紀錄發炎狀況及飼主觀察，將兩評分作為治療效果的評估。合計發炎狀況及飼主觀察的評分為口炎總分，總分於治療後第四週(p = 0.0006)及第六週(p = 0.0002)，與治療前有顯著差異。治療六週後，17 隻貓的平均改善程度為 40%，13 隻貓的改善程度為 3 隻(3/17, 18%)為顯著改善，5隻(5/17, 29%)為中度改善，5 隻(5/17, 29%)為輕度改善，其餘4 隻(4/17, 24%)則是無明顯改善。在六週治療療程中，肝臟及腎臟指數並無明顯變化。根據本研究結果，ATRIron® 為一個極具潛力、可改善復發型貓慢性齒齦口炎之輔助治療製劑。
並列摘要
Feline chronic gingivostomatits (FCGS) is painful and inflammatory disease of the oral cavity. The pathogenesis of FCGS is currently unknown and is thought to be due to inappropriate immune response to multifactorial antigen. Following extraction of the premolar and molar teeth, most of the cats had significant clinical improvement, but others still had little or no improvement that need to constant medical treatment, namely refractory FCGS. Interferons (IFNs)-ω, a type I IFNs, characterized by antiviral, anti-proliferative, and immunomodulatory activities. A new feline recombinant interferon-omega (rFeIFN-ω; ATRIron®) was produced from the bacterial production system by the Animal Technology Laboratories of the Agriculture Technology Research Institute. The purpose of this study is using the rFeIFN-ω as an additional agent to treat the refractory FCGS cats. Clinical signs, semi-quantitative scoring system of veterinarian and owner, photographic records of oral lesion and possible side effects recorded on 0, 2, 4, 6 weeks after subcutaneous administration of rFeIFN-ω. The total stomatitis score (Feline chronic gingivostomatitis activity index, FCGSAI), defined as the veterinarian plus the owner score, was significant differences on 4 and 6 weeks than on day 0 (p= 0.0006 and 0.0002, respectively). Mean improvement in total stomatitis scores among cats in the treatment group after 6 weeks was 40%. Thirteen cats responded to treatment by marked improvement (n=3), moderate improvement (n=5) and mild improvement (n=5). Four cats were non-response. During 6-week assessment, there was no detectable influence on liver function. These results demonstrate that additional agent of rFeIFN-ω might be improved in refractory FCGS cats.