tropisetron and Autoimmune-Diseases

The 5-HT3-receptor antagonist tropisetron has a favourable effect on the pain, not only of primary but also of secondary fibromyalgia. In an open study, ten women with clinical and serological evidence of secondary fibromyalgia were treated with tropisetron. Treatment comprised a single daily injection of 5 mg tropisetron on five consecutive days. Prior to, and 7 and 14 days after, treatment, the patients rated their pain on the visual analog pain (VAP) scale.. Nine patients experienced a substantial reduction in pain, with the mean VAP score decreasing from 64.3 initially, to 31.9 on the 7th day. After 14 days, the average score was 33.3, that is, roughly the same as that recorded after 7 days; however, 3 patients indicated the reappearance of substantially greater pain.. On the basis of these preliminary results, it would appear to be worth initiating a double-blind study to investigate the effects of short-term i.v. treatment with tropisetron in a large, clearly defined patient population with secondary fibromyalgia.

Topics: Adult; Aged; Antibodies, Antinuclear; Autoimmune Diseases; Female; Fibromyalgia; Humans; Indoles; Injections, Intravenous; Middle Aged; Pain Measurement; Serotonin 5-HT3 Receptor Antagonists; Serotonin Antagonists; Treatment Outcome; Tropisetron

To characterize the immune modulatory effects of 5-HT3 receptor antagonist treatment in patients with fibromyalgia, autoimmune disorders, and chronic pain.. Multiplex-assisted cytokine measurements were performed before and during treatment. Whole blood stimulation with TNF-alpha was carried out to determine the proinflammatory response induced by exogenous TNF-alpha.. Five of nine patients clinically responded to treatment, and two had a moderate response. All patients had significantly elevated levels of T-H1 cytokines more prominent than TNF-alpha, IL-1beta, and IL-6. Treatment resulted in transient effects on peripheral monocyte counts in all but one patient, a plasma IL-1beta increase in two responder patients, and decreased T-H1 cytokines in two responder patients. Ex vivo TNF-alpha stimulation was transiently reconstituted in three responder patients to a significant level. Three patients showed a marginal reconstitutive response.. 5-HT3 receptor blockade transiently affects monocyte tissue infiltration, modulates T-H1 cytokines in clinical responders as well as MIP-1beta in moderate responders, and transiently affects the ex vivo response to exogenous TNF-alpha.

Topics: Adult; Aged; Autoimmune Diseases; Chronic Disease; Fibromyalgia; Humans; Immune System; Indoles; Middle Aged; Pain; Serotonin 5-HT3 Receptor Antagonists; Serotonin Antagonists; Tropisetron