RESUMEN
Multiple pharmacological interventions tested over the last decades have failed to reduce ARDS mortality. This short note recounts past data indicating that (i) neutrophils home along an IL-8 gradient, (ii) in ARDS, massive neutrophil accumulation and degranulation in and along bronchoalveolar spaces contributes to damage and hypoxia, (iii) large increases in IL-8 are one of the chemotaxic signals drawing neutrophils to the ARDS lung, and (iv) old data from dermatology and glioblastoma research showed that the old drug against Hansen's disease, dapsone, inhibits neutrophils' chemotaxis to IL-8. Therefore dapsone might lower neutrophils' contributions to ARDS lung pathology. Dapsone can create methemoglobinemia that although rarely problematic it would be particularly undesirable in ARDS. The common antacid drug cimetidine lowers risk of dapsone related methemoglobinemia and should be given concomitantly.
Asunto(s)
Antiinfecciosos/uso terapéutico , Dapsona/uso terapéutico , Neutrófilos/efectos de los fármacos , Síndrome de Dificultad Respiratoria/tratamiento farmacológico , Antiinfecciosos/farmacología , Cimetidina/uso terapéutico , Dapsona/farmacología , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Metahemoglobinemia/inducido químicamente , Metahemoglobinemia/prevención & controlAsunto(s)
Cimetidina/farmacología , Tolerancia Inmunológica/efectos de los fármacos , Lepra/inmunología , Activación de Linfocitos/efectos de los fármacos , Factores Supresores Inmunológicos/biosíntesis , Cimetidina/uso terapéutico , Etiopía , Humanos , Inmunidad Celular/efectos de los fármacos , Lepra/tratamiento farmacológico , Linfocitos/efectos de los fármacos , Linfocitos/metabolismoRESUMEN
To test the capacity of cimetidine to enhance cellular immunity in patients with lepromatous leprosy (LL), cimetidine was given for one month to 29 inactive LL patients and 3 active LL patients. Immune function was monitored with skin tests (lepromin, PPD, candida, and trichopytin), lymphocyte transformation tests (phytohemagglutinin, BCG, and Dharmendra lepromin), and quantitation of peripheral blood lymphocyte subpopulations. A small but significant "booster" response to PPD was the only change observed in the study of patients with inactive disease, and leprosy-related reactions did not occur. In the few active LL patients studied, neither immune enhancement nor leprosy-related reactions were observed. The results of this investigation suggest that cimetidine can be used safely in patients with inactive lepromatous leprosy.