acyclovir and Asthma

Acyclovir (9-[2-hydroxyethoxymethyl] guanine), an inhibitor of the DNA polymerase of the herpes virus, has been reported to exhibit pharmacologic activity other than antiviral activity, including antiasthmatic effects.. This study was designed to investigate the protective effect of acyclovir on airway responsiveness to the sulpyrine provocation test and to investigate whether this protective activity is associated with a reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4 ), a marker of cysteinyl leukotriene (LT) overproduction that participates in the pathogenesis of aspirin-induced asthma.. We assessed the effects of pretreatment with acyclovir on bronchoconstriction precipitated by inhalation of sulpyrine in 16 adult patients with mild or moderate aspirin-induced asthma; those who were in stable clinical condition and were hyperresponsive to the sulpyrine provocation test were allocated to this study. A double-blind, randomized, cross-over design was used. u-LTE4 was measured by a combined reverse-phase HPLC enzyme immunoassay.. Acyclovir protects against aspirin-induced attacks of asthma through mechanisms unrelated to its bronchodilator property but related to the improvement of bronchial hypersensitivity to sulpyrine; protection was nearly complete in all patients (P <.0001). By contrast, after acyclovir, the maximum level of u-LTE4 in patients was significantly lower than that in control subjects (P <. 01).. Our results suggest that acyclovir is not only an antiviral drug but also an inhibitor of analgesic-induced bronchoconstriction, probably acting by inhibiting the release of cysteinyl LTs.

Topics: Acyclovir; Administration, Oral; Adult; Anti-Asthmatic Agents; Aspirin; Asthma; Bronchoconstriction; Cross-Over Studies; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Leukotriene E4; Male; Middle Aged; Vital Capacity

We report a case of side effects caused by the increase in plasma theophylline concentration after coadministration of aciclovir had been started during theophylline therapy. Interaction between theophylline and aciclovir has not previously been reported. Therefore, a study of the pharmacokinetic and metabolic interactions between theophylline and aciclovir was carried out in five healthy male volunteers. All subjects received a single oral dose of 320 mg theophylline (aminophylline, 400 mg) after they had taken oral aciclovir 800 mg five times daily for two consecutive days. The area under the curve from 0 to infinity of theophylline (AUC0-infinity) after coadministration of aciclovir was increased from 189.9 +/- 18.2 to 274.9 +/- 34.3 micrograms.h/ml (p < 0.01), and total body clearance was decreased from 28.4 +/- 2.9 to 19.8 +/- 2.5 ml/h/kg (p < 0.01). Further, there was a significant increase in urinary theophylline and decreases in urinary 1,3-dimethyluric acid and 1-methyluric acid after coadministration of aciclovir. The decrease in total body clearance is likely to have resulted from inhibition of metabolism via the oxidation pathway. The results indicated that with aciclovir therapy lower doses of theophylline might be necessary and careful monitoring of plasma concentrations was essential.

Topics: Acyclovir; Adult; Animals; Antiviral Agents; Area Under Curve; Asthma; Biotransformation; Bronchodilator Agents; Drug Interactions; Female; Fluorescence Polarization Immunoassay; Humans; Male; Middle Aged; Models, Biological; Rats; Theophylline; Time Factors

Bell's palsy is an acute facial paralysis with known association to viral infections. We describe a medically complex 6-year-old male with hyper IgM syndrome who presented with unilateral facial droop and positive SARS-CoV-2 RT-PCR. This is the first reported pediatric case of Bell's palsy in the setting of SARS-CoV-2 infection.

Topics: Abnormalities, Multiple; Acyclovir; Antiviral Agents; Asthma; Bell Palsy; Child; Cleft Palate; COVID-19; Gastrostomy; Glucocorticoids; Heart Septal Defects, Atrial; Heart Septal Defects, Ventricular; Humans; Hyper-IgM Immunodeficiency Syndrome; Hypospadias; Immunoglobulins, Intravenous; Immunologic Factors; Male; Prednisolone; SARS-CoV-2; Sleep Apnea, Obstructive

Disseminated herpes zoster infection occurs mostly in immunocompromised hosts. There have been recent reports of disseminated zoster with chemotherapeutic regimens and newer monoclonal antibodies.. The present case describes a 61-year-old patient presenting with disseminated herpes zoster after initiation of benralizumab, an anti-IL-5 monoclonal antibody for severe persistent asthma. His initial vesicular lesions limited to left lumbar dermatomes progressed extensively resulting in dissemination on his body. The diagnosis was confirmed with PCR and he had remarkable clinical improvement with acyclovir and supportive medical management.. Clinical trials have reported an association of mepolizumab, another anti-IL-5 monoclonal antibody with herpes zoster. This report of herpes zoster following initiation of benralizumab might suggest a possibility of a class effect of anti-IL-5 monoclonal antibody.

Topics: Acyclovir; Antibodies, Monoclonal, Humanized; Asthma; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Male; Middle Aged; Treatment Outcome

Topics: Acyclovir; Adult; Antiviral Agents; Asthma; Cloxacillin; Dermatitis, Atopic; Humans; Kaposi Varicelliform Eruption; Male; Staphylococcal Infections; Superinfection

Although acyclovir (9-(2-hydroxyethoxymethyl) guanine) is an antiviral drug that inhibits DNA polymerase of herpes virus, we have had the experience of an asthmatic patient's peak flow rate being improved by oral administration of acyclovir.. The aim of this experiment is whether acyclovir has anti-asthma effects using an asthma model in guinea-pigs.. The airway response was induced by a single inhalation of calcium ionophore A23187 (2 mg/mL). The airway obstruction was estimated by the ratio of expiration to inspiration time (E/I). The peribronchial eosinophil infiltration and eosinophil influx into bronchoalveolar lavage (BAL) fluid 7 h after the inhalation were also examined. To assess the effects of acyclovir (1, 10, and 100 mg/kg), aminophylline (20 mg/kg) and pemirolast potassium (TBX, 20 mg/kg) on A23187-induced asthmatic response, the drugs were intraperitoneally administered before the inhalation.. The immediate airway obstruction was significantly suppressed by acyclovir (10 mg/kg) and aminophylline, whereas different doses of acyclovir (1 and 100 mg/kg) and TBX showed only a small inhibitory effect on the airway obstruction. On the other hand, the peribronchial eosinophilia was most successfully inhibited by TBX. Acyclovir (10 mg/kg) and aminophylline also suppressed the eosinophilia significantly. Furthermore, acyclovir significantly suppressed eosinophil influx into BAL fluid, whereas aminophylline and TBX weakly suppressed the influx.. These results suggest that acyclovir exhibits not only antiviral but also antiasthma activity.

Topics: Acyclovir; Aminophylline; Animals; Anti-Asthmatic Agents; Antiviral Agents; Asthma; Bronchi; Bronchoalveolar Lavage Fluid; Bronchoconstriction; Calcimycin; Eosinophils; Guinea Pigs; Histamine Antagonists; Humans; Male; Middle Aged; Peak Expiratory Flow Rate; Pyridines; Pyrimidinones; Time Factors

A 49 year old man with a long history of severe chronic asthma, treated with oral corticosteroids and weekly doses of methotrexate, contracted chickenpox from his son whose chickenpox rash had developed three weeks before presentation. Five days before admission the patient developed a vesicular skin rash which became extensive, with general malaise, bilateral pneumonia, and acute deterioration of his asthma. He died two weeks after admission despite treatment with acyclovir.

Topics: Acyclovir; Asthma; Chickenpox; Fatal Outcome; Humans; Immunosuppression Therapy; Male; Methotrexate; Middle Aged; Pneumonia, Viral; Radiography

Topics: Acyclovir; Administration, Inhalation; Adrenal Cortex Hormones; Asthma; Causality; Chickenpox; Child; Child, Preschool; Humans; Immunoglobulins, Intravenous; Risk Factors

Topics: Acyclovir; Adult; Asthma; Chickenpox; Child; Female; Humans; Male; Steroids