Publicado por: Criba
Asunto: Re: No puedo con esta enfermedad
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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”
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