quinagolide and Lupus-Erythematosus--Systemic

The objective of this study was to determine the effect of quinagolide (Norprolac) on serum level of cytokines in systemic lupus erythematosus (SLE) patients. In 20 SLE patients treated with a low dose of quinagolide, and in 17 healthy persons who constituted the control group, concentration of serum prolactin (PRL), interleukins (ILs), soluble tumor necrosis factor receptors (sTNF Rs) preceded by calculation of disease activity index (SLEDAI) were tested at entry and then after 3 months in 16 patients and after 6 months in 11 patients who completed the study. Serum PRL level was higher (though insignificantly) in the SLE group than in the controls and decreased significantly after 6 months of therapy. A raised SLEDAI score at entry was significantly reduced during therapy but a weak correlation with PRL level was revealed. A significant increase in IL-6 level in SLE group as compared to controls was observed (respectively 14.57 +/- 13.25 and 5.04 +/- 3.35 microg/ml) as well as a significantly decreased level after 6 months of treatment (4.30 +/- 2.51 pg/ml). There was a significant difference between sTNF RI concentration before and after 3 months of quinagolide treatment (respectively 1140.83 +/- 312.08 and 1454.58 +/- 465.54 pg/ml). After 6 months of treatment a statistically significant correlation between concentration of PRL and level of IL-6 and a negative correlation between PRL and sTNF RI was revealed. Quinagolide treatment may have a role in the management of SLE patients.

Topics: Adult; Aminoquinolines; Dopamine Agonists; Female; Humans; Interleukin-10; Interleukin-6; Lupus Erythematosus, Systemic; Male; Prolactin; Prospective Studies; Receptors, Tumor Necrosis Factor; Severity of Illness Index

The case of a rare coexistence of myasthenia gravis (MG) with systemic lupus erythematosus (SLE) is described. MG was diagnosed prior to SLE which developed after thymectomy. The patient was affected by HCV viremia. Therefore, there were therapeutic problems. Metylase treatment was continued for several years and dopamine receptor agonist was effectively administered as adjunctive therapy in SLE.

Topics: Adult; Aminoquinolines; Contraindications; Dopamine Agonists; Female; Glucocorticoids; Hepacivirus; Humans; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Myasthenia Gravis; Thymectomy; Treatment Outcome; Viremia

The objective of this study was to determine the expression of transforming growth factor-beta1 messenger RNA (TGF-beta1 mRNA) and the expression of mRNA for TGF-beta receptors (TGF-beta Rs mRNA) in whole peripheral blood of consecutive (treated from several months to several years) systemic lupus erythematosus (SLE) patients (21 women). A further aim of this study was to evaluate the association between expression of the above mentioned parameters in relation to the form of applied therapy (9 patients treated with quinagolide and 12 with quinagolide plus prednisone, azathioprine or cyclosporine A). The control group consisted of 15 healthy women. Most of the patients had mild SLE with SLE disease activity index (SLEDAI) score < 10 at time when blood samples were collected. Laboratory measurements included real-time polymerase chain reaction (RT-QPCR). The expression levels of TGF-beta1 mRNA and mRNA for TGF-beta RII and RIII were significantly lower in patients whereas the expression level of TGF-beta RI was statistically significantly higher in SLE patients than in the controls. A very high positive correlation between TGF-beta1 mRNA expression and expression levels of TGF-beta Rs mRNA was found. In compared subgroups selected according to the form of the applied therapy no statistically significant differences were observed. We conclude that the TGF-beta signaling pathway can be altered in circulating leukocytes derived from treated patients with SLE and that the assumed forms of the applied therapy in the group of patients under consideration are accompanied by similarity in the expression level of transcripts for TGF-beta1 and TGF-beta Rs determined in whole blood. In our investigations, we cannot exclude the influence of the disease itself on the obtained results.

Topics: Adolescent; Adult; Aminoquinolines; Azathioprine; Cyclosporine; Dopamine Agonists; Dose-Response Relationship, Drug; Female; Humans; Lupus Erythematosus, Systemic; Middle Aged; Prednisone; Receptors, Transforming Growth Factor beta; RNA, Messenger; Transforming Growth Factor beta1

The relationship between endocrine regulation and immune system has recently become the subject of intense investigations. The objective of this study was to determine the extent of selected serum acute phase proteins (APP), IL-6 and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) involvement in systemic lupus erythematosus (SLE) patients during quinagolide therapy. A further aim of this study was to evaluate the relationships between the above mentioned parameters. In 25 SLE patients treated with a low dose of quinagolide (12.5-50 microg per day) and in 25 healthy persons who constituted the control group, serum concentration of C-creative protein (CRP), alpha-1-antitripsin (AAT), ceruloplasmin (CER), IL-6 and prolactin (PRL) were estimated at entry and in patients after 3 months of treatment. Moreover, SLEDAI score was calculated at entry and after 3 months of therapy with quinagolide. IL-6 and PRL levels were significantly higher in SLE group whereas the concentrations of CRP, AAT and CER were higher than in the controls, but without statistical significance. After 3 month therapy statistically significant decrease of serum level of IL-6 and PRL was revealed. Statistically significant lower serum concentration of CER was also obtained after 3 months of therapy whereas serum CRP and AAT concentration was lower compared with the mean pretreatment level but the results did not reach statistical significance. A raised SLEDAI score at entry was significantly reduced after 3 month therapy and positive correlation with PRL level in examined group of patients with SLE was noted at entry. The decreased serum concentration of IL-6, APP and SLEDAI score observed during applied therapy with small dose of quinagolide confirms the hypothesis that quinagolide may become a valuable and safe drug in the therapy of patients with mild SLE.

Topics: Acute-Phase Proteins; Adolescent; Adult; Aged; Aminoquinolines; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Interleukin-6; Lupus Erythematosus, Systemic; Male; Middle Aged; Prospective Studies

Prolactin has been shown to have immunomodulatory as well as lactogenic effects. Generally less well known is that prolactin may also play a role in the activity of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Studies have shown decreasing prolactin production to be beneficial in animal models of autoimmune disease. Thus far, double-blinded, placebo-controlled studies of dopamine agonist treatment in humans with autoimmune disease have been done only in lupus patients, and support the potential efficacy of such agents. Small, open-label trials have also suggested potential benefit in patients with rheumatoid arthritis, Reiter's syndrome, and psoriasis. More studies are required to further delineate the mechanisms by which prolactin affects autoimmune disease activity, to determine in which specific diseases prolactin plays a significant role, and to test the efficacy of prolactin-lowering agents as therapy for such diseases.

Topics: Aminoquinolines; Animals; Arthritis, Rheumatoid; Autoimmune Diseases; Bromocriptine; Cabergoline; Cyclosporine; Dopamine Agonists; Double-Blind Method; Drug Therapy, Combination; Ergolines; Female; Humans; Hyperprolactinemia; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Male; Mice; Mice, Knockout; Penicillamine; Prednisone; Prolactin; Rats; Receptors, Prolactin

Topics: Adult; Aminoquinolines; Biomarkers, Tumor; Clinical Trials as Topic; Dopamine Agonists; Humans; Lupus Erythematosus, Systemic; Middle Aged; Peptides; Severity of Illness Index