肺結核の短期化学療法-2-実験結核症による短期療法モデル実験の成績

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In order to confirm the favorable clinical results achieved in short-course chemotherapy foipulmonary tuberculosis with rifampicin (RFP), ethambutol (EB) and isoniazid (INH) for 9 months, as reported in the first paper, experimental short-course chemotherapies of murine tuberculosis were carried out using RFP, EB, INH and streptomycin (SM) in either single or combined administration. The survival rate of mice was observed in one experiment, and the viable number of tubercle bacilli in the lung was counted after their inoculation with tubercle bacilli. 0.5mg (4.5-4.9×106CFU/ml) of Kurono strain cultured on a 1% Ogawa egg medium for three weeks was inoculated through a tail vein to male mice of dd strain, weighing approximately 20g. The mice were divided into 8 groups after inoculation with tubercle bacilli; a control group (no treatment), groups treated singly either with SM, INH, RFP or EB, and groups with RFP and INH, RFP, INH and EB, RFP, INH and SM in combination. Each group consisted of 10 to 20mice. The mice were divided into 8 groups after inoculation with tubercle bacilli; a control group (no treatment), groups treated singly either with SM, INH, RFP or EB, and groups with RFP and INH, RFP, INH and EB, RFP, INH and SM in combination. Each group consisted of 10 to 20mice. In the first experiment animals were kept without chemotherapy for 4 days, then started on the 10-day chemotherapy according to the specific regimens. 0.4mg of SM, 0.1mg of INH and 0.4mg of EB were in jected intraperitoneally, and 0.1mg of RFP was administered to the mice orally for 10 days. The regimen of RFP plus INH was more effective than regimens of RFP or INH alone in the experiment, according to the survival rate of the animals. However the addition of SM or EB to the regimen of RFP plus INH did not increase it's effectiveness in chemotherapy for murine tuberculosis. In the second experiment, animals were treated with 1mg of SM by intraperitoneal injection, and 0.4mg of INH, 0.4mg of RFP and 0.8mg of EB by oral administration. The viable counts of tubercle bacilli in the lung tissue of mice were reduced in a shorter time in animal groups treated with regimens of RFP and INH, RFP, INH and SM, RFP, INH and EB than in the groups treated with single drug regimens. The viable number of bacilli in the lungs became negative in all animals 3 months after treat ment with combined drugs. These groups were then divided into two, one in which the regimen was discontinued and another in which the same regimen was administered for additional 3 months (totalling 6 months). In the former animal group, regrowth of tubercle bacilli in the lungs was seen, and in the latter, negative finding continued. These results will be useful in conducting clinical short-course chemotherapy for pulmonary tuberculosis.
一般社団法人日本結核病学会の論文

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小田敏郎
長崎大学医学部第2内科

肺結核の短期化学療法-2-実験結核症による短期療法モデル実験の成績

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