Long-Term Pulmonal Therapy of Cystic Fibrosis-Patients with Amitriptyline

被引:25
作者
Adams, Constantin [1 ]
Icheva, Vanya [1 ]
Deppisch, Caroline [1 ]
Lauer, Josefine [1 ]
Herrmann, Gloria [1 ]
Graepler-Mainka, Ute [1 ]
Heyder, Susanne [1 ]
Gulbins, Erich [2 ,3 ]
Riethmueller, Joachim [1 ]
机构
[1] Univ Hosp Tuebingen, Dept Paediat, Tubingen, Germany
[2] Univ Duisburg Essen, Dept Mol Biol, Essen, Germany
[3] Univ Cincinnati, Dept Surg, 231 Bethesda Ave, Cincinnati, OH 45267 USA
关键词
Cystic Fibrosis; Amitriptyline; Ceramide; CFTR; PSEUDOMONAS-AERUGINOSA; CERAMIDE; SPHINGOMYELINASE; IDENTIFICATION; INFLAMMATION; GENE; METABOLISM; INFECTION; CHILDREN; CELLS;
D O I
10.1159/000445648
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
Background/Aims: Several recent clinical studies revealed an accumulation of ceramide in bronchial epithelial cells of patients with cystic fibrosis (CF). Degradation of ceramide concentrations in lungs of CF patients employing the functional acid sphingomyelinase inhibitor amitriptyline revealed a benefit in lung function, weight and exacerbation rates. Methods: To test for a beneficial effect of amitriptyline in vivo, we performed two phase II randomised, double-blind, placebo-controlled studies. CF patients were treated with 25 mg amitriptyline twice daily, i.e. a total dose of 50 mg/d. After those two studies part of the patients used amitriptyline in an off-lable-use for routine treatment. These patients were observed after one, two and three years after continuous use of amitriptyline and were matched with those patients who were not treated. These patients were used as a control group. Results: After one year of treatment, forced expiratory volume in 1 sec predicted (FFV1) increased significantly by 7.6 +/- 7.0%, p= <0.001, and weight increased by 2.1 +/- 2.3kg, p= <0.001 in the amitriptyline population (n=20), whereas FEV1 decreased significantly in the control group by 1.8 +/- 3.3%, p=0.010, and weight increased by 1.1 +/- 2.7kg, p=0.010 (n=14). After two years of treatment, FEV1 increased significantly by 5.6 +/- 10.3%, p=0.009, and weight increased by 3.6 +/- 2.9kg, p= <0.001 in the amitriptyline population (n=12). In contrast, FFV1 decreased in the control group by 2.1 +/- 3.7%, p=0.051 and weight increased by only 0.4 +/- 2.9kg, p=0.31 (n=10). After three years of treatment, FEV1 increased significantly by 7.7 +/- 8%, p=0.050, and weight increased by 7.3 +/- 3.8kg, p=0.016, in the amitriptyline population (n=5), whereas FFV, decreased in the control group by 1.0 +/- 1.3%, p=0.075 and weight increased by 0.4 +/- 1.5kg, p=0.29 (n=5). Conclusion: Amitriptyline significantly increases FEV1, reduces ceramide in lung cells and increases weight of CF patients. (C) 2016 The Author(s) Published by S. Karger AG, Basel
引用
收藏
页码:565 / 572
页数:8
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