AEGiS-CATIE: IMMUNOMODULATORS: Small study finds no benefit with Trental(R)

IMMUNOMODULATORS: Small study finds no benefit with Trental(R)

TreatmentUpdate 68, Volume 8, No 4; May-June 1996
Sean Hosein

Background

Cytokines are chemicals produced by the immune system. They include interferons and interleukins. The immune system releases certain cytokines to help recruit cells and to manage the fight against infections. Once the infection is cleared other cytokines are released which help turn off the immune system. Originally, doctors found that TNF-alpha (tumour necrosis factor-alpha) helped destroy certain tumours. Today, it is clear that TNF-alpha also helps the immune system fight certain bacterial infections. However, production of high levels of TNF-alpha may cause weight loss and even increase production of HIV in infected cells. In lab experiments on cells, the drug Trentalr (pentoxifylline) reduces production of TNF-alpha therefore, some doctors think that this drug should be tested in people with HIV/AIDS.

The Danish study

Doctors in Copenhagen were able to enrol 14 HIV-infected subjects for this study. They gave subjects pentoxifylline 800 mg three times daily for 6 weeks. After the sixth week doctors stopped giving them the drug but continued to monitor the subjects for another 6 weeks. Four subjects left the study because of the "gastrointestinal side effects" and another 4 had to leave because they were not taking the drug as directed. The remaining 6 subjects (2 female, 4 male) had an average CD4+ cell count of 229 cells before they received pentoxifylline.

Results

Strangely, despite the high dose of pentoxifylline used, levels of TNF-alpha in the blood samples of the six subjects were not reduced nor was the overall health of subjects improved. However, high doses of pentoxifylline did not reduce the number or performance of white blood cells.

REFERENCES:

1. Krause A, Rieneck K, Kappel M, et al. Pentoxifylline therapy in HIV seropositive subjects with elevated TNF. Immunopharmacology 1995;31:85-95.

2. Han X, Becker K, Degen N, et al. Synergistic stimulatory effects of tumour necrosis factor alpha and interferon gamma on replication of human immunodeficiency virus type 1 and on apoptosis of HIV-1-infected host cells. European Journal of Clinical Investigation 1996:26:286-292.

3. Sathe SS, Tsigler D, Sarai A and Kumar P. Pentoxifylline impairs macrophage defence against Mycobacterium avium complex . Journal of Infectious Diseases 1995;172:863-866.

960501
CATE6802

Always watch for outdated information. This article first appeard in 1996. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1996 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1996. AEGIS.