Case Report of International Journal of Case Reports
Transfer Factor Revisited: Treatment of Congenital Cytomegalovirus Infection
J. Kelly Smith1,2*
1Department of Academic Affairs, James H. Quillen College of Medicine, East Tennessee State University, USA
2Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, USA
A 7-month-old girl with congenital cytomegalovirus (CMV) infection underwent an immune assessment in anticipation of Transfer Factor therapy. She had been symptomatic since birth, with jaundice, rhinorrhea, diarrhea, pneumonia, hepatosplenomegaly, chorioretinitis, hydrocephalus (for which she was shunted), motor retardation, and failure to thrive. Her sputum and urine cultures were positive for CMV and her IgM anti-CMV antibody titer was positive at 1:16-1:32 dilutions. Her baseline immune assessment was normal except for a failure of her peripheral blood mononuclear cells to produce migratory inhibitory factor in response to CMV antigen. Treatment with transfer factor prepared from CMV seropositive donors resulted in clinical improvement, clearance of the virus, normal migratory inhibition factor responses to CMV antigen, and subsequent development of normal growth and development parameters.
Keywords: Transfer factor, dialyzable leukocyte extract, cytomegalovirus, congenital cytomegalovirus, migration inhibition factor, immunotherapy, CMV, MIF, ganciclovir, valganciclovir.
How to cite this article:
J. Kelly Smith. Transfer Factor Revisited: Treatment of Congenital Cytomegalovirus Infection. International Journal of Case Reports, 2019 4:61. DOI: 10.28933/ijcr-2019-02-2005
1. Landsteiner K, Chase MW (1942). Experiments on transfer of cutaneous sensitivity to simple compounds. Proc Soc Exp Biol Med 49: 688-690.
2. Lawrence HS (1949). The cellular transfer of cutaneous hypersensitivity to tuberculin in man. Proc Soc Exp Biol Med 71: 516-522.
3. Lawrence HS (1969). Transfer factor. Advances in Immunol 11: 195-266.
4. Rozzo SJ, Kirkpatrick CH (1992). Purification of transfer factors. Mol Immunol 29: 167-182.
5. Marsico C, Kimberlin DW. Congenital cytomegalovirus infection: advances and challenges in diagnosis, prevention and treatment. Ital J Pediatr. 2017;43:38. doi:10.1186/s13052-017-0358-8.
6. Dreher AM, Arora N, Fowler KB, Novak Z, Britt W, Boppana SB, et. al. Spectrum of disease and outcome in children with symptomatic congenital cytomegalovirus. J Pediatr. 2014;164:855-859.
7. Boppana SB, Ross SA, Fowler KB. Congenital cytomegalovirus infection: clinical outcome. Clin Infect Dis. 2013;57 Suppl 4:178-181.
8. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol. 2007;17:253-276.
9. Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007;17:355-363.
10. Grosse SD, Ross DS, Dollard SC. Congenital cytomegalovirus (CMV) infection is a cause of permanent bilateral hearing loss: a quantitative assessment. J Clin Virol. 2008;41:57-62.
11. Kimberlin DW, Jester PM, Sánchez PJ, Ahmed A, Arav-Boger R, Michaels MG et. al. National institute of allergy and infectious diseases collaborative antiviral study group: Valganciclovir for symptomatic congenital cytomegalovirus infection. N Engl J Med. 2015;372:933-943.
12. Kimberlin DW, Acosta EP, Sánchez PJ, Sood S, Agrawal V, Homans J. National institute of allergy and infectious diseases collaborative antiviral study group: pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease. J Infect Dis, 2008;197:836—845.
13. Rawlinson WD, Boppana SB, Fowler KB, Kimberlin DW, Lazzarotto T, Alain S, et. al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis and therapy. Lancet Infect Dis. 2017. doi: 101016/S1473-3099(17)30143-3.
14. Kimberlin DW, Lin CY, Sánchez PJ, Demmier GJ, Dankner W, Shelton M. National institute of allergy and infectious diseases collaborative antiviral study group, et al. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Pediatr. 2003;143:16-25.
15. Bauer PW, Parizi-Robinson M, Roland PS, Yegappan S. Cytomegalovirus in the perilymphatic fluid. Laryngoscope. 2005;115:223-225.
16. Rivera LB, Boppana SB, Fowler KB, Britt WJ, Stagno S, Pass RF. Predictors of hearing loss in children with symptomatic congenital cytomegalovirus infection. Pediatrics. 2002:110:762-767.
17. Thomas IT, Soothill JF, Hawkins GT, Marshall WC. Transfer-factor treatment in congenital cytomegalovirus infection. Lancet. 1977; 2(8047):1056-1057.
18. Stubbs EG, Budden SS, Burger DR, Vandenbark AA. Transfer factor immunotherapy of an autistic child with congenital cytomegalovirus. J Autism Dev Disord. 1980; 10(4):451-458.
19. Paganelli R, Soothill JF, Marshall WC, Hamblin AS. Transfer factor and cytomegalovirus viruria. Lancet. 1981; 1(8214):273-274.
20. Rytel MW, Aaberg TM, Dee TH, Heim LH. Therapy of cytomegalovirus retinitis with transfer factor. Cell Immunol. 1975; 19(1):8-21.
21. Krishnaveni M. A review on transfer factor an immune modulator. Drug Intervention Today. 2013; 5:153-156.
22. Goldstein AL, Badamchian M (2004). Thymosins: chemistry and biological properties in health and disease. Expert Opin Biol Ther 4: 559-573.
23. Tuthill C, Rios I, McBeath R (2010). Thymosin alpha 1: past clinical experience and future promise. Ann NY Acad Sci 1194: 130-135.
24. Pierluigi B, D’Angelo C, Fallarino F, Moretti S, Zelante T, Bozza S, et al (2010) Thymosin α 1: the regulator of regulators? Ann NY Acad Sci 1194: 1-5.
25. Romani L, Bistoni F, Gaziano R, Bozza S, Montagnoli C, Perruccio K, et al (2004) Thymosin α 1 activates dendritic cells for antifungal Th1 resistance through Toll-like receptor signaling. Blood 103: 4232-4239.
26. Romani L, Bistoni F, Montagnoli C, Gaziano R, Bozza S, Bonifazi P, et al (2007) An endogenous regulatory of inflammation, immunity, and tolerance. Ann NY Acad Sci. 1112: 326-338.
27. Matteucci C, Minutolo A, Sinibaldi-Vallebona P, Palamara AT, Rasi G, Mastino A, et al (2010) Transcription profile of human lymphocytes following in vitro treatment with thymosin alpha-1. Ann NY Acad Sci 1194: 6-19.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.