Views for Future Development Cytokines in Health and Disease: Implications for Clinical Medicine

The cytokines e.g. IFN-, IL-2, IFN-, G-CSF, GM-CSF and TNF have made tremendous impact in Clinical Medicine (Internal Medicine as well as Laboratory Medicine) either as the potential therapeutic agents or because they can be usefully quantitated in various clinical situations. The therapeutic impacts of cytokines have been felt mainly in the areas of cancer, infectious diseases, blood disorders, rheumatic and autoimmune diseases. However, the occurrence of potentially dangerous complications demands that highly trained and well informed physicians and nursing staffs should be available in centres where cytokines are to be introduced either as therapy or as clinical trial. The medical research and therapy with cytokines have enormous implications in Laboratory Medicine in terms of trained manpower, equipments and costs for commercially available assay kits including efficiency and accuracy of the assay results. The cytokine assay should therefore be based in laboratories where professionally trained immunologists and technical staffs are available, and where the results can be put ethically to further usage as research data, and where improvements in the efficacy and accuracy of the assay results are under routine surveillance. To bring these fruits of advance medical research in 'cytokines' to the developing countries, the authorities concerned should make provisions now for professionally trained manpower (physician and nursing staff, clinical immunologists and medical technologists) and technology (assay kits and equipments) in their national health service planning. This will facilitate the introduction of cytokines in clinical medicine in the third world countries in the very near future.