Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with severe asthma who require long-term oral corticosteroid therapy are at risk of unwanted effects. Several immunosuppressive drugs have been assessed as corticosteroid-sparing agents in chronic asthma. We previously showed that cyclosporin A (CsA) administered for 12 wk improved lung function in corticosteroid-dependent patients. We have now investigated the corticosteroid-sparing properties of CsA over a 36-wk period. Following a 4-wk run-in period, 39 corticosteroid-dependent asthmatic patients were randomized to receive CsA (19 patients, initial doses 5 mg/kg/d) or matched placebo (20 patients) for 36 wk. Attempts were then made by a physician ignorant of the trial therapy to reduce their prednisolone dosages at 14-d intervals, provided that a patient's asthma remained stable or improved. Three patients receiving CsA had to be withdrawn from the study before they completed 12 wk of therapy. The remaining 16 patients achieved a statistically significant reduction in median daily prednisolone dosage of 62% (10 to 3.5 mg), compared with a decrease of 25% (10 to 7.5 mg) in the patients taking placebo (p = 0.043). This reduction was most pronounced during the last 12 wk of active therapy. In addition, morning peak expiratory flow rate (PEFR) improved significantly (mean 9.4%, SEM 3.0%) in the active-treatment group but not in the placebo group (p = 0.026 between groups). Predictable changes in renal function and blood pressure, and an increased incidence of hypertrichosis and paresthesia, were observed in the patients treated with CsA, but these did not necessitate withdrawal from the study, and were reversed during a 4-wk run-out period. Thus, low-dose CsA therapy, as compared with placebo, allowed a significant reduction in oral corticosteroid dosages in patients with severe asthma, and also improved lung function.
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PMID:Double-blind, placebo-controlled study of cyclosporin A as a corticosteroid-sparing agent in corticosteroid-dependent asthma. 881 Jun 26

Spinal cord stimulation (SCS) has been used in the treatment of "chronic failed back surgery syndrome" for many years. To evaluate long-term results and cost effectiveness of SCS, we interviewed 69 patients treated during a period of 13 years. Twenty-six patients stopped using SCS; there was no clear explanation for this unsatisfactory result in 10. Forty-three patients continued with the therapy and obtained good pain relief. Electrode breakage either spontaneous or due to a procedure to obtain better stimulation paresthesias was more frequent in the radiofrequency-coupled system group than in the battery group (mean +/- SEM 2.81 +/- 2.0 versus 1.42 +/- 1.51, respectively; P = 0.0018). Ten patients obtained better pain relief than during the trial procedure. Some still need opioid analgesics, but 11 of the 16 who require these drugs obtained a synergistic effect when concomitantly using the stimulator. Eleven patients have returned to work. In our center, the application of SCS costs on average $3660 per patient per year. Although this seems expensive, it may be a cost-effective treatment if other therapies fail.
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PMID:Spinal cord stimulation: a valuable treatment for chronic failed back surgery patients. 918 35

Stromal cell-derived factor-1 (SDF-1/CXCL12) plays a key regulatory role in the trafficking of hematopoietic cells. AMD3100 is a specific antagonist of the binding of SDF-1 to its receptor, CXCR4. This phase I study assessed the hematological effects, pharmacokinetics, and safety of administration of AMD3100 to 32 healthy volunteers, including its ability to mobilize CD34+ hematopoietic progenitor cells. A generalized leukocytosis occurred after a single subcutaneous injection of AMD3100 (80 microg/kg) resulting in a maximum white blood cell count of 19.49 +/- 1.27 x 103/microL (mean +/- SEM) at 6 hours. No changes were observed in erythrocyte or platelet counts. Circulating CD34+ cells increased 5-fold after administration of AMD3100 at 80 mug/kg and 15.5-fold in response to AMD3100 at 240 mug/kg, both at 9 hours after injection. Myeloid progenitor cells-colony forming unit granulocytemacrophage (CFU-GM); CFU-granulocyte, eosinophil, monocyte, megakaryocyte (CFU-GEMM); and burst forming units-erythroid showed similar increases in mobilization to the blood with increasing doses of AMD3100. The mobilized cells were in a slow or noncycling state as determined by in vitro high specific activity of 3H-thymidine. Pharmacokinetic studies showed a near linear increase in peak drug levels with increasing doses and nearly complete elimination of the drug by 24 hours. AMD3100 was well tolerated with only mild and transient toxicities (injection site erythema, headache, paresthesia, nausea, and abdominal distension) observed. These observations suggest that AMD3100 may be a clinically useful agent for hematopoietic progenitor cell mobilization.
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PMID:Leukocytosis and Mobilization of CD34+ Hematopoietic Progenitor Cells by AMD3100, a CXCR4 Antagonist. 1862 38