An in vitro and in vivo study of cytokines in the acute-phase response associated with bisphosphonates.

Détails

ID Serval
serval:BIB_579D3AF4B436
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
An in vitro and in vivo study of cytokines in the acute-phase response associated with bisphosphonates.
Périodique
Calcified Tissue International
Auteur⸱e⸱s
Thiébaud D., Sauty A., Burckhardt P., Leuenberger P., Sitzler L., Green J.R., Kandra A., Zieschang J., Ibarra de Palacios P.
ISSN
0171-967X (Print)
ISSN-L
0171-967X
Statut éditorial
Publié
Date de publication
11/1997
Peer-reviewed
Oui
Volume
61
Numéro
5
Pages
386-392
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Résumé
We studied the acute phase response, including specific cytokine production, [interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor alpha(TNF alpha)] following a single dose of Aredia (disodium pamidronate) in patients with increased bone turnover and, in vitro, the role played by specific cytokines in the acute-phase reaction which may follow the administration of aminobisphosphonates. An in vivo exploratory study was done on 24 in- and outpatients with increased bone turnover given a single intravenous dose of pamidronate 60 mg. Measurements were taken at baseline and at 24, 48, and 72 hours. The main outcome measures were changes from baseline in serum IL-1, IL-6, and TNF alpha. In addition, C-reactive protein (CRP), white blood cell count (WCC), lymphocyte count, and elastase concentration were measured. Symptomatic evaluation was made of fever, bone pain, and rigors. In vitro, whole blood from eight healthy volunteers was exposed to various concentrations of the three bisphosphonates--pamidronate, clodronate, and zoledronate. Measurements were taken immediately before and at 3, 6, and 10 hours after exposure to drugs. The main outcome measures were changes in serum IL-1, IL-6, and TNF alpha. In vivo, there was a statistically significant (P < 0.001) increase in median values of TNF alpha in all post-baseline measurements. Median values for IL-6 also showed a significant (P < 0.001) increase at 24 hours after dosing. There were no statistically significant changes in median IL-1 values. Few patients showed any change from baseline in total WCC or in lymphocyte count, but 62.5% of patients with normal range baseline values for CRP increased to above normal levels after treatment. Fourteen patients experienced fever; 2 reported rigors. There was no correlation between fever and changes in cytokines. There were no serious adverse experiences or premature discontinuations due to poor tolerability, and 91% of the patients expressed willingness to receive pamidronate again. In vitro, an increase in TNF alpha and a mild increase in IL-6 was seen with all bisphosphonates, with the greatest effects seen with the highest concentration of both pamidronate and zoledronate. No changes were observed in IL-1 with any agent. Significant changes in both TNF alpha and IL-6 were observed within 3 days of a single dose of pamidronate in patients treated for the first time confirming previous findings. However, the lack of change in IL-1 in vivo and in vitro does not support the hypothesis that this cytokine plays a major role in the acute phase reaction. The cellular mechanism of the interaction among aminobisphosphonates, IL-6, and TNF alpha requires further investigations. The results of the in vitro study are consistent with the in vivo findings.
Mots-clé
Acute-Phase Reaction/blood, Acute-Phase Reaction/metabolism, Adult, Bone Diseases/blood, Bone Diseases/drug therapy, Carrier Proteins/metabolism, Clodronic Acid/administration & dosage, Clodronic Acid/therapeutic use, Diphosphonates/administration & dosage, Diphosphonates/therapeutic use, Female, Humans, Imidazoles/administration & dosage, Imidazoles/therapeutic use, Injections, Intravenous, Interleukin-1/blood, Interleukin-6/blood, Leukocyte Count/drug effects, Male, Middle Aged, Tumor Necrosis Factor-alpha/analysis
Pubmed
Web of science
Création de la notice
25/01/2008 9:52
Dernière modification de la notice
20/08/2019 14:11
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