Biological Agents IFNa

Recombinant IFN-a has antiviral as well as immunomodulating properties and is considered to be associated in many aspects with the pathogenesis of autoimmune diseases. High amounts of IFN have been detected in the serum of patients with LE (Shou-Nee et al. 1987), and it has been speculated that increased IFN levels could result from a homeostatic attempt to control aberrant immune reactions in LE (Huddlestone et al. 1979). However, IFN-a and IFN-y were found to accelerate the course of the autoimmune diseases in mice and to induce, even in normal mice, the development of an autoimmune nephropathy (Schattner 1988). Moreover, in many conditions, systemic application of IFN-a was associated with the development of autoantibodies (Fleischmann et al. 1996). However, there is also evidence from two clinical studies that IFN-a may improve the clinical course of certain autoimmune diseases (Nicolas et al. 1990, Tebbe et al. 1992). One study reports on IFN-a treatment of 10 patients with DLE or SCLE. Some of the patients were pretreated with hydroxy-chloroquine, systemic or topical corticosteroids, or thalidomide with or without clinical improvement. Before initiating IFN-a treatment, patients were not allowed to receive specific treatment for at least 1 month. After an average treatment duration of 6 weeks at a mean dose of 35x106 units of IFN-a per week, five of six patients with DLE experienced an improvement in their skin lesions. Similar results were obtained in three of four patients with SCLE, but time until remission was longer (~10 weeks), and a mean weekly dose of 80x106 units of IFN-a was required. In one patient with SCLE receiving IFN-a, an exacerbation of skin lesions was observed, and one patient did not respond to IFN-a treatment. Although, IFN-a therapy may lead to the improvement of CLE, in particular DLE, its mode of action in diseases with an autoimmune pathogenesis is still obscure. Currently, one has to evaluate very carefully the initiation of IFN therapy in patients with LE because the induction of autoantibodies on application of IFN has to be considered. Moreover, there is evidence for the induction of an LE-like disease in patients being treated with IFN-a for other reasons (Ronnblom et al. 1990).

Hair Loss Prevention

Hair Loss Prevention

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