LETTER
Host-Directed Therapy for AIDS
Raphael B. Stricker, MD, and
Billi Goldberg
15 September 1995 | Volume 123 Issue 6 | Pages 471-472
TO THE EDITOR:
The thoughtful article by Lederman [1] explores the use of host-directed and immune-based therapies as an alternative approach to human immunodeficiency virus (HIV) disease. Curiously, the article ignores the most widely used alternative immune-based HIV treatment: topical dinitrochlorobenzene (DNCB).
A simple organic compound, DNCB has been used for many years as a skin test reagent by dermatologists [2]. The therapeutic use of topical DNCB in patients with HIV disease was first proposed in 1986. Since then, the immune-boosting effect of this compound has been shown in HIV-infected patients worldwide [3, 4]. Dinitrochlorobenzene is a potent stimulant of delayed-type hypersensitivity skin reactivity through its effect on epidermal Langerhans cells, dendritic cells, and other antigen presenting cells. The delayed-type hypersensitivity response is known to stimulate TH1 cellular immune function that is now thought to play an important role in controlling HIV disease [5].
It is estimated that DNCB is used by thousands of HIV-infected patients around the world at a cost of pennies per week; however, a controlled trial of DNCB in HIV disease has only recently been organized. Lederman's article reflects the stubborn determination of much of the medical community to ignore this promising immune-based therapy for AIDS. I hope that attitude will change.
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Author and Article Information
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HemaCare Corporation; San Francisco, CA 94108
DNCB Study Group; San Francisco, CA 94114
1. Lederman MM. Host-directed and immune-based therapies for human immunodeficiency virus infection. Ann Intern Med. 1995; 122:218-22.
2. Stricker RB, Elswood BF, Abrams DI. Dendritic cells and dinitrochlorobenzene (DNCB): a new treatment approach to AIDS. Immunol Lett. 1991; 29:191-6.
3. Stricker RB, Elswood BF, Goldberg B, Dumlao C, Van Elk J, Henry J, et al. Clinical and immunologic evaluation of HIV-infected patients treated with dinitrochlorobenzene (DNCB). J Am Acad Dermatol. 1994; 31:462-6.
4. Traub A. Use of DNCB as an immune modulator in HIV-positive patients-a pilot study. [Abstract]. Int Conf AIDS. 1994; 10:219.
5. Roberts M, Gompels M, Pinching A, Knight SC. Dendritic cells from HIV-1 infected individuals show reduced capacity to stimulate autologous T-cell proliferation. Immunol Lett. 1994; 43:39-43.
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