Animo Mila,

Desanimarse de vez en cuando es normal y si quieres hasta beneficioso (siempre que funcione como un resorte). Lo que veo peligroso es permanecer en el desanimo. Habituarse a él es fácil pero impide disfrutar plenamente de lo bueno y no mejora en absoluto lo malo, al contrario, todo parece peor de lo que realmente es. En el fondo se ayuda a la enfermedad a arrebatar más calidad de vida de la que ella ya te quita. Así que ánimo y, cuando tengas momentos bajos, desahógate todo lo que quieras, ya sabes que aquí nos tienes y aquí se te comprende.

Me acabo de encontrar un artículo he inmediatamente me has venido a la cabeza. Por desgracia solo he conseguido un resumen, pero como trabajas en un hospital no creo que tengas problemas para tenerlo completo y comentarlo con tu medico si, completo, sigue siendo interesante. Lo único que me mosquea es que si dio tan buenos resultados (aunque con una serie corta) debería haber más sobre esa línea pero con resultado distinto. Buscaré.

Por cierto. ¿Es tan “clavadito papa, clavadito” el Dr. Fontán a Dumbledore el maestro de Harry Potter?.


S. Della Bella _9 M. Vanoli _9 S. Bazzi _9 R. Scorza
Successful treatment of common variable immunodeficiency
and related disorders with cimetidine and zinc sulphate

Received: 25 July 1996 / Accepted: 9 November 1996
Key words Common variable immunodeficiency -
Cimetidine - Zinc sulphate

Common variable immunodeficiency (CVI), selective IgA
deficiency, and hyper lgM hypogammaglobulinemia are
human antibody deficiency disorders clinically characterized
by recurrent bacterial and/or parasitic infections. Periodic
parenteral administration of immunoglobulins and
judicious use of antibiotics are the current but expensive
treatments of these diseases. Recent therapeutic approaches
based on the administration of recombinant interleukins
able to promote the growth and differentiation of
T and B lymphocytes are no less expensive [1, 2].
We report (Table 1) the favorable clinical results obtained
in seven patients with antibody deficiency disorders,
all with severe recurrent bacterial infections, treated with
cimetidine and zinc sulfate, a cheap and safe combined immunopotentiating
treatment shown to be effective in recurrent
viral infections [3]. All patients were given cimetidine
(400 mg, three times a day) and zinc sulfate (400 mg daily,
then adjusted to maintain blood zinc levels at the upper
normal range) for a mean period of 17.1 months. During
the study none of the patients was treated with immunoglobulin
therapy; adequate antimicrobial agents were administered
when needed clinically. No adverse side effects
were observed in any patient. All but one patient experienced
marked clinical improvement, with significantly
fewer bacterial infections during cimetidine and zinc sulfate
administration than during the pre-treatment period,
and the clinical improvement persisted for a long time after
discontinuation of treatment.
As shown in Table I, pre-treatment infections in patients
with selective IgA deficiency were similar to those
of patients with CVI; since patients with selective IgA de-
S. Delia Bella (~), M. Vanoli. S. Bazzi _9R . Scorza
Institute of Internal Medicine, Infectious Diseases
and Immunopathology, IRCCS Ospedale Maggiore di Milano,
Pad. Granelli, Via F. Sforza 35, 1-20122 Milan, Italy
ficiency, who are frequently asymptomatic, come to our attention
only when suffering from recurrent infections, it is
likely that they were selected for severity of clinical manifestations.
The combined treatment was not particularly effective
in patients 4 and 5 with selective IgA deficiency. These
two patients did not differ from the other patient with selective
IgA deficiency in the in vitro proliferative response
to polyclonal mitogens or in the distribution of lymphocyte
subpopulations (data not shown). However, they had
increased pre-treatment levels of serum IgG (3,006 and
2; 160 mg/dl, respectively), in contrast to normal IgG levels
in the other patient with selective IgA deficiency
(935 mg/dl); this could reflect heterogeneity of the mechanisms
underlying the disease.
In CVI and related disorders, abnormalities have been
described in the regulatory T cells which modulate B cell
maturation and antibody production; cimetidine is known
to affect immune responses by blocking H2-receptor-mediated
suppressor cell activity [4]. However, in our patients
serum immunoglobulin levels were not modified by treatment
(nor was a correlation found between the immunoglobulin
levels and the frequency and/or severity of the infections,
data not shown), thus suggesting that the favorable
clinical effect is not due to restoration of the specific
immune response. Segal et al. [5] also described a patient
with CVI treated with cimetidine in whom a significant
clinical improvement was achieved, despite the fact that
there were no changes in immunoglobulin secretion in vitro
and levels of immunoglobulins in the serum. Zinc is
perhaps the most important trace element for immune function
[6], and oral zinc supplementation has been proven to
correct the immunological abnormalities and to reduce the
frequency of infectious diseases in may conditions with
even marginal zinc deficiency [7]. Cimetidine and zinc sulfate,
acting on T lymphocytes, natural killer cells, and/or
macrophages, may also influence the production of cytokines
involved in non-specific immune responses [8.9].
We suggest that the clinical efficacy of our treatment might
be due to the enhancement of such adaptive responses.
which also play a central role in antibacterial defense.




Espero haberte arrancado una sonrisa. En España hay dos referentes en inmunología, uno es el Dr. Fontán, el otro es nuestra querida Dra. Español (Zeus y Atenea). En ese sentido no puedes estar en mejores manos.

Un animoso abrazo.


“Señor. Tú, que nos has hecho seres racionales, líbranos de las ideas preconcebidas”