Interferon: The Science and Selling of a Miracle Drug (review)

This book chronicles the political, scientific, social, and medical history of interferon, beginning with the identification of a nondescript viral interference factor through the present day, where interferon is used to treat a broad spectrum of disorders, including viral infection, cancer, and multiple sclerosis. The expressed purpose of the book is to educate students studying the history of medicine and science about the interaction of key players—industry, government, academic and clinical researchers, doctors, patients, and the media—involved in the development of a powerful yet controversial drug. As a professor of the history of pharmacy and medicine, the author presents the information from a strictly historical perspective that is not entertaining, scientific, or politically motivated.

As for content, the book starts with coverage of the introduction of interferon to the public in the spring of 1958, when interferon was touted as the new "anti-viral penicillin." In the next decade, enthusiasm for the potential of interferon dampened moderately, but interest increased again in the 1970s, when interferon was identified as a potential cancer treatment. In the 1980s, some of the interest in interferon for cancer therapy waned. Yet in the 1990s, interferon began being used as a therapeutic agent with other treatments for a broad spectrum of diseases.

Obscurity as to the nature of interferon accounted for some of the dampened enthusiasm in early lab investigations. Following the recognition of a viral interference factor/viral inhibitory factor, later named interferon, there were problems in lab-to-lab reproducibility of results. Some of these problems were due to inherent instability in the protein, as well as a lack of a standardized method for scientists to utilize. As investigations proceeded, it became clear that some of the problems with reproducibility were due to the fact that interferon is actually a family of biomolecules whose members exhibit host specificity.

Early collaborative programs to test interferon met with frustrations, resulting from production problems. These early attempts to test interferon on humans were limited by the shortage of interferon for clinical use. However, the discovery of foreign nucleic acids as inducers of interferon production prompted some scientists to use interferon stimulators to meet their research objectives, avoiding the expense of interferon production. Through these difficulties, interferon continued to be thought of as medically important but scarce and costly.

The problem of expense led to the use of genetically engineered bacteria to produce large quantities of pure interferon. Once interferon could be produced in large quantities for a reasonable price, it began to be marketed as a therapy. Marketing campaigns emphasized the unique property of interferon to enhance the body's own defense mechanisms, therefore eliminating the potential for grave side effects. However, the perceived lack of detrimental side effects was found to be inaccurate. In humans, interferon caused many flu-like symptoms. Nevertheless, a subtype of interferon, interferon beta, began to be used as a therapy for multiple sclerosis in the 1990s, and it continues to be studied by many scientists interested in its ability to act as a biological response modifier/cytokine.

Overall, this book presents a detailed survey of historical factors leading up to research on interferon and its clinical use. It is suitable for students interested in medical history. However, it does not give a favorable outlook for interferon in the future. While interferon is known to have side effects, its potent ability to inhibit viral replication and to reduce virally mediated mortality requires more effort from the scientific community to understand its functions. The potential exists to identify downstream effectors of interferon inducible anti-viral pathways that will avoid the unwanted side effects of interferon alone.