Since the discovery of the protein "Interferon" over 50 years ago, interferon beta, an antiviral cytokine, has been well studied. In particular, the pathways inducing this cytokine during viral infection have been characterized, leading to the discovery of a multitude of pattern recognition receptors. Interferon beta is also induced during bacterial infection, following recognition of bacterial ligands by the host viral and DNA sensors. However, the function of interferon beta during bacterial infection is variable and sometimes detrimental to the host.
Using interferon-alpha (IFN-alpha) as the conventional therapeutic antiviral drug, physicians generally achieve a treatment success of <50% in cases with chronic hepatitis C. Owing to the structural similarities between interferon-alpha and interferon-beta (IFN-beta), the latter is a candidate for obtaining sustained viral response (Fig. 1).
Interferon beta 1a is a drug to treat multiple sclerosis (MS). It is produced by mammalian cells. Interferon beta-1a is sold under the trade names Avonex (Biogen Idec) and Rebif (Merck Serono); CinnoVex (CinnaGen) is biosimilar. Subcutaneous recombinant interferon-beta-1a (Rebif) 22 or 44 microg three times weekly is a valuable option in the first-line treatment in patients with relapsing-remitting multiple sclerosis. It has shown benefits on outcome measures related to relapses, progression of disability, and magnetic resonance imaging in clinical trials. A significant efficacy advantage for subcutaneous interferon-beta-1a three times weekly over intramuscular interferon-beta-1a 30 microg once weekly was shown at 24 and 48 weeks. The most common adverse events are generally mild and clinically manageable. Considering both direct and indirect comparative clinical trial data, an assessment suggests that subcutaneous interferon-beta-1a 44 microg three times weekly has the best benefit-to-risk values of the available disease-modifying drugs used to treat relapsing-remitting multiple sclerosis.
Interferon beta 1b is a drug to treat the relapsing-remitting and secondary-progressive forms of multiple sclerosis (MS). It is produced by modified E.coli. Interferon beta-1b is sold under the tradenames Betaferon, Betaseron (North America), Extavia and ZIFERON. Interferon beta-1b is available only in injectable forms, and can cause skin reactions at the injection site that may include cutaneous necrosis. Tacrolimus is a calcineurin inhibitor which works to induce immune suppression by preventing cytokine transcription and lymphocyte activation. Combining the immunomodulator interferon beta-1b (Betaseron) with the immunosuppressant tacrolimus (Prograf) may have the potential of additive therapeutic benefit through the complementary mechanisms of action of these two therapeutics.