Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THALIDOMIDE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2002

Effects of thalidomide, cytochrome P-450 and TNF-alpha on angiogenesis in a three-dimensional collagen gel-culture.

The anti-angiogenic effects of thalidomide were examined in mouse aortae grown in a three-dimensional collagen gel-culture. In our in vitro model, (+/-)-thalidomide and (-)-thalidomide exhibited no anti-angiogenic effects. On the other hand, when the culture was treated with thalidomide plus cytochrome P-450, both types of thalidomides significantly inhibited angiogenesis. Co-administration of 100 microg/ml thalidomide plus 200 microg/ml cytochrome P-450 inhibited angiogenesis more strongly than thalidomide plus cytochrome P-450 at other concentrations (10 microg/ml + 200 microg/ml and 100 microg/ml + 20 microg/ml). To study the relation between the anti-angiogenic effect and TNF-alpha, we also evaluated the concentration of TNF-alpha in the culture medium. We found that the concentration of TNF-alpha was correlated to the strength of the anti-angiogenic effect. The inhibition of angiogenesis by thalidomide and cytochrome P-450 takes place through a suppression of TNF-alpha and involves the metabolism of the thalidomide.

Angiogenesis Inhibitors↗
PubMed2004

Salvage therapy for hepatocellular carcinoma with thalidomide.

AIM: To evaluate the clinical benefit of thalidomide in patients with advanced hepatocellular carcinoma (hepatoma). METHODS: From March 2000 to July 2002, patients who had advanced hepatocellular carcinoma and failed to or were unsuited for aggressive treatment, were enrolled and took thalidomide 150 to 300 mg/d. All cases were followed till April 2003. Data collection included viral hepatitis, grade of cirrhosis, total dosage of thalidomide, side effect, stage of hepatoma by Okuda and CLIP classification, and prognosis. The subjects were divided into A and B groups, depending on 5 000 mg dosage of thalidomide. Survival time of all cases and in the two subgroups was evaluated. RESULTS: Ninety-nine patients with hepatoma were enrolled, 81 men and 18 females with median age 58+/-14.1 years. Eighty-six percent had viral hepatitis and one case was alcoholism. Hepatoma was diagnosed with histology, alpha-fetoprotein (aFP) >400 ng/mL, or image examination, there were 30, 33 and 36 cases respectively. At the time of thalidomide therapy, more than 81% had cirrhotic status. Twenty-two patients were in group A (< 5 000 mg) with median survival time about 25 days, for 77 cases in group B (> =5 000 mg) the median survival time was about 109 days. Six subjects had partial response. Most adverse effects were skin rush, neuropathy, somnolence, and constipation. CONCLUSION: Several patients responded to thalidomide therapy. As a single drug therapy, thalidomide might not have good therapeutic effect for all cases, but a small ratio of patients had exciting response, the resistance or tumor escape would develop after long-term use. Up to now, no defined facts could be used to predict response. The effect of thalidomide on hepatoma might be associated with the dosage. As salvage therapy, thalidomide has its value. Combination or adjuvant therapy will be the next trial.

Adult↗
PubMed2006

Efficacy and safety of thalidomide in patients with hepatocellular carcinoma.

AIM: To evaluate which patients with hepatocellular carcinoma (HCC) are most likely to respond to thalidomide treatment. METHODS: From July 2002 to July 2004, patients with HCC who received thalidomide treatment, were enrolled. We extracted relevant data from the patients' medical records, including history and type of hepatitis, comorbidity, serum alpha-fetoprotein (alpha-FP) level, volumetric changes in tumor, length of survival, and the dose, duration, side effects of thalidomide treatment. The tumor response was evaluated. On the basis of these data, the patients were divided into two groups: those with either partial response or stable disease (PR + SD group) and those with progressive disease (PD group). RESULTS: Two of 42 (5%) patients had a partial tumor response after treatment with thalidomide, 200 mg/d, and 9 (21%) had stable disease. Patients in the PR + SD group all had cirrhosis. Comparing patients with and without cirrhosis, the former were more likely to respond to thalidomide therapy (PR + SD: 100% vs PD: 64.5%, P = 0.041 < 0.05). Thalidomide was significantly more likely to be effective in tumors smaller than 5 cm (PR + SD: 63.6% vs PD: 25.8%, P = 0.034 < 0.05). Compared with patients with progressive disease (PD), patients in the PR + SD group had a higher total dose of thalidomide (13669.4 +/- 8446.0 mg vs 22022.7 +/- 11461.4 mg, P = 0.023 < 0.05) and a longer survival (181.0 +/- 107.1 d vs 304.4 +/- 167.1 d, P = 0.047 < 0.05). Patients with comorbid disease had a significantly greater incidence of adverse reactions than those without (93.8% vs 60.0%, P = 0.021 < 0.05). The average number of adverse reactions in each person with a comorbid condition was twice as high as in those without other diseases (2.2 +/- 1.3 vs 1.1 +/- 1.2; P = 0.022 < 0.05). CONCLUSION: Thalidomide therapy is most likely to be effective in patients with early stage small HCC, especially in those with other underlying diseases. A low dose (200 mg/d) of thalidomide is recommended to continue the treatment long enough to make it more effective.

Adult↗
PubMed2002

Thalidomide suppresses NF-kappa B activation induced by TNF and H2O2, but not that activated by ceramide, lipopolysaccharides, or phorbol ester.

Thalidomide ([+]-alpha-phthalimidoglutarimide), a psychoactive drug that readily crosses the blood-brain barrier, has been shown to exhibit anti-inflammatory, antiangiogenic, and immunosuppressive properties through a mechanism that is not fully established. Due to the central role of NF-kappaB in these responses, we postulated that thalidomide mediates its effects through suppression of NF-kappaB activation. We investigated the effects of thalidomide on NF-kappaB activation induced by various inflammatory agents in Jurkat cells. The treatment of these cells with thalidomide suppressed TNF-induced NF-kappaB activation, with optimum effect occurring at 50 microg/ml thalidomide. These effects were not restricted to T cells, as other hematopoietic and epithelial cell types were also inhibited. Thalidomide suppressed H(2)O(2)-induced NF-kappaB activation but had no effect on NF-kappaB activation induced by PMA, LPS, okadaic acid, or ceramide, suggesting selectivity in suppression of NF-kappaB. The suppression of TNF-induced NF-kappaB activation by thalidomide correlated with partial inhibition of TNF-induced degradation of an inhibitory subunit of NF-kappaB (IkappaBalpha), abrogation of IkappaBalpha kinase activation, and inhibition of NF-kappaB-dependent reporter gene expression. Thalidomide abolished the NF-kappaB-dependent reporter gene expression activated by overexpression of TNFR1, TNFR-associated factor-2, and NF-kappaB-inducing kinase, but not that activated by the p65 subunit of NF-kappaB. Overall, our results clearly demonstrate that thalidomide suppresses NF-kappaB activation specifically induced by TNF and H(2)O(2) and that this may contribute to its role in suppression of proliferation, inflammation, angiogenesis, and the immune system.

Antigens, CD↗
PubMed2002

[In vitro inhibition and mechanism of multiple myeloma cells growth by thalidomide].

To investigate the influence of the thalidomide on the growth of multiple myeloma cells from untreated, relapsed or refractory patients and summarize its mechanisms, thalidomide influence on colony growth of untreated, relapsed or refractory multiple myeloma cells cultured by semisolid methylcellulose was observed. The level of interleukin-6 (IL-6) autosecreted by myeloma cells was tested by IL-6-dependent cell line when myeloma cells were treated with thalidomide at 200 microgram/ml, and in the same concentration of thalidomide the expression of IL-6 receptor were tested by flow cytometry. Results showed that colony growths of myeloma cell from untreated and relapsed or refractory patients were all colonies were inhibited when treated by thalidomide up to 75 microgram/ml or 100 microgram/ml concentration. The inhibition was concentration-dependent, higher concentration cause more inhibition. After treatment with thalidomide at 200 microgram/ml, the concentrations of IL-6 secreted by myeloma cells were (148.5 +/- 96.7) microgram/ml, and the levels of IL-6 receptor expressed on the cell surface were 16.7% and 20.2% in untreated and relapsed or refractory patients, respectively, and those were significantly lower than those levels in the cells before exposure to thalidomide. It was concluded that thalidomide can inhibit growth of both relapsed or refractory cells and untreated myeloma cells in vitro. Therefore, it can be used to treat untreated multiple myeloma patients. Inhibiting tumor cells secreting level of IL-6 and reducing the expression of IL-6 receptor on myeloma cell surface is one of the mechanisms for thalidomide to remedy multiple myeloma patients

Angiogenesis Inhibitors↗
PubMed2003

Effects of thalidomide on the expression of angiogenesis growth factors in human A549 lung adenocarcinoma cells.

Angiogenesis is a critical step for the growth and metastasis of solid tumors, and it is a major therapeutic target for the development of anti-angiogenics for cancer treatment. Thalidomide is reported to be an anti-angiogenic agent, which is currently in phase II clinical trials for the treatment of advanced malignancies. However, the mechanism of thalidomide in angiogenesis is not completely understood. This study was undertaken to investigate the effect of thalidomide on the expression of angiogenesis growth factors in human lung cancer cells. In this report, we show that thalidomide downregulated the mRNA and protein expression of basic fibroblast growth factor (bFGF) in the human lung adenocarcinoma cell line A549, and that the effect of thalidomide was time and concentration-dependent. In contrast, the expression of vascular endothelial growth factor (VEGF) by thalidomide in these cells was in two phases. The mRNA and protein expression of VEGF was increased in the lung cancer cells treated with 0.6-6 microg/ml thalidomide, while higher concentrations of thalidomide decreased VEGF levels significantly in these cells. These data suggest that the anti-angiogenic or antitumor activity of thalidomide may be partly mediated through the regulation of the levels of angiogenesis growth factors.

Adenocarcinoma↗
PubMed2006

[Thalidomide therapy for discoid lupus erythematosus].

INTRODUCTION: Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus. Thalidomide has been reported as an effective treatment in at least 200 cases of severe DLE. In this article we studied the efficacy and adverse effects of thalidomide in 10 patients with disseminated DLE. METHODS: This report presents the retrospective evaluation of 10 patients treated with thalidomide in our department during the period 1996-2005. RESULTS: All patients treated with thalidomide had been unresponsive to at least two other systemic treatments. The patients were treated with low-dose thalidomide of 50-200 mg per day. The dose was tapered after a clinical remission. All patients had a favorable response within 6 weeks. Of 10 patients 9 had complete regression of lesions. Four patients remain free of disease without maintenance treatment and 5 patients relapsed after cessation of thalidomide. All relapses responded after the reinstitution of the drug. The side effects of thalidomide treatment were mostly transient. The most common adverse effects were sedation and weight gain. Two patients developed peripheral sensory neuropathy resolved with discontinuation of thalidomide. Two patients of premenopausal age reported amenorrhea. CONCLUSION: Low-dose thalidomide treatment is an effective treatment option for discoid lupus erythematosus in cases resistant to other treatments. It is essential to be conversant with all the precautions in order to minimize the risks of side effects.

Amenorrhea↗
PubMed1995

Does thalidomide affect IL-2 response and production?

The exact mechanism of immunosuppression by thalidomide is poorly understood. A common denominator in the pathogenesis of graft-vs.-host disease, graft rejection, reactional lepromatous leprosy, and autoimmune disorders modulated by thalidomide is the activation of T lymphocytes culminating in the synthesis of interleukin-2 (IL-2), the expression of high-affinity IL-2 receptors, and the induction of proliferation. We investigated the effect of thalidomide on the production of IL-2 by the human leukemia cell line Jurkat through induction of IL-2 gene enhancer activity and through the presence of IL-2 in supernatants. beta-galactosidase activity, encoded by a reporter lac z construct and controlled by a transcription factor in thalidomide-treated PMA- and ionomycin-stimulated Jurkat cells, was similar (97 +/- 1.33%; p > 0.1) to non-thalidomide-treated controls at all drug concentrations tested. IL-2 enhancer-driven beta-galactose activity of thalidomide-treated and stimulated cells was also similar to that of untreated controls (p > 0.2). The IL-2 production of activated nontransfected Jurkat cells was gauged by using the IL-2-dependent cell line HT-2 as a readout and by ELISA. Jurkat cells were subcloned by limiting dilution. Bulk cultures and three subclones (J.5.2.5., J.5.2.9., and J.5.3.8.) were assayed at 6, 12, and 24 hours after PHA/PMA-induced stimulation. No inhibitory effect on the IL-2 production by thalidomide could be detected at any of the drug concentrations tested (5-30 micrograms/mL), whereas 10 to 100 ng/mL of cyclosporine inhibited the IL-2 production by 95 to 100%. In addition, we observed neither inhibition of IL-2-dependent proliferation of HT-2 nor inhibition of PHA-induced proliferation of peripheral mononuclear cells by thalidomide at all drug concentrations used (5-30 micrograms/mL). These results do not support the possibility of a modulatory effect on the immune response by thalidomide via IL-2 production and IL-2 response.

Cells, Cultured↗
PubMed2002

Potentiation of the antitumour effect of cyclophosphamide in mice by thalidomide.

PURPOSE: Thalidomide has recently shown significant promise in the treatment of some types of cancer, and trials in combination with conventional chemotherapy are being undertaken. We wished to determine whether thalidomide potentiated the effect of cyclophosphamide, a commonly used cytotoxic drug, in a murine tumour model. METHODS: C57Bl/6 mice implanted with subcutaneous Colon 38 tumours were treated with cyclophosphamide alone or together with thalidomide as a single intraperitoneal injection and tumour growth was measured. Concentrations of cyclophosphamide, 4-hydroxycyclophosphamide, 4-ketocyclophosphamide and 2-dechloroethylcyclophosphamide were determined in plasma, liver and tumour tissue using coupled high-performance liquid chromatography-mass spectrometry at different times after treatment. RESULTS: Cyclophosphamide alone (220 mg/kg) induced growth delays of 11-13 days with no cures, whereas cyclophosphamide together with thalidomide (100 mg/kg) cured mice of their tumours. Thalidomide at lower doses (1-20 mg/kg) also potentiated the antitumour effect. Coadministration of thalidomide (100 mg/kg) dramatically decreased the clearance of cyclophosphamide and its metabolites from plasma and tissue, with corresponding increases in the area under the concentration-time curves. The magnitude of the effect was dependent on the dose of thalidomide over the range 1-20 mg/kg with no further effect at a dose of 100 mg/kg. CONCLUSIONS: Coadministration of thalidomide and cyclophosphamide gave markedly greater activity against Colon 38 tumour compared with either drug alone. Investigation of the reason for this effect revealed thalidomide to possess the novel property of dramatically decreasing the clearance of cyclophosphamide and its metabolites.

Animals↗
PubMed2001

Phase II study of the antiangiogenesis agent thalidomide in recurrent or metastatic squamous cell carcinoma of the head and neck.

BACKGROUND: Thalidomide has been shown to have antiangiogenic effects in preclinical models as well as a significant antitumor effect in hematologic tumors such as multiple myeloma. The authors performed this Phase II study to determine the activity, toxicity profile, and antiangiogenic effect of thalidomide in patients with locoregionally recurrent or metastatic squamous cell carcinoma of the head and neck. METHODS: Twenty-one patients with recurrent or metastatic squamous cell carcinoma of the head and neck were treated with single-agent thalidomide. All patients had received radiation therapy, and most had undergone surgery (95%) and/or chemotherapy (90%). Thalidomide was initiated at 200 mg;3>daily and increased to a target dose of 1000 mg daily. Patients continued treatment until disease progression, unacceptable toxicity, or death occurred. RESULTS: All 21 patients eventually developed progressive disease. Median time to progression was 50 days (95% confidence interval, 28-70), with median overall survival time of 194 days (95% lower confidence boundary, 151), similar to the progression and survival times reported for this patient group with other agents. Thalidomide was generally well tolerated, with few patients experiencing Grades 3 to 4 toxicities. Serum vascular endothelial growth factor and basic fibroblast growth factor levels increased in six of seven patients, for whom paired serum samples were available and all of whom had progressive disease. CONCLUSIONS: In this heavily pretreated population of patients with advanced squamous cell carcinoma of the head and neck, thalidomide does not appear to have single-agent antitumor activity. Further evaluation of the mechanism of action of thalidomide is indicated. Potentially, future evaluations of thalidomide may be performed in combination with other antiangiogenic or cytotoxic agents in patients with earlier stage disease or in patients with minimal residual disease.

Administration, Oral↗
PubMed2005

Concurrent determination of thalidomide in rat blood, brain and bile using multiple microdialysis coupled to liquid chromatography.

A rapid and sensitive system of liquid chromatography coupled with microdialysis was developed for the simultaneous determination of unbound thalidomide in rat blood, brain and bile for pharmacokinetic study. Microdialysis probes were concurrently inserted into the jugular vein toward the right atrium, the brain striatum and the bile duct of the anesthetized Sprague-Dawley rats for biological fluid sampling after the administration of thalidomide (5 mg kg(-1)) through the femoral vein. Thalidomide and dialysates were separated using a Zorbax ODS C(18) column and a mobile phase comprising acetonitrile-methanol-0.1 mm 1-octanesulufonic acid (32:3:65, v/v/v, pH 5.3) at flow rate of 1 mL min(-1). The UV wavelength was set at 220 nm. The concentration-response relationship was linear (r(2)>0.995) over a concentration range of 0.025--25 microg mL(-1). The intra-assay and inter-assay precision and accuracy of thalidomide fell within 7%. The average in vivo recoveries were 0.31+/- 0.02,0.046+/- 0.004 and 0.57+/- 0.02 (n=6), respective to the dialysates of blood, brain and bile, with thalidomide at concentrations 2, 5 and 10 microg mL(-1). The disposition of thalidomide in the blood, brain and bile fluid suggests that there is a rapid thalidomide exchange and equilibration between the blood and brain systems. In addition, thalidomide undergoes hepatobiliary excretion.

Animals↗
PubMed1983

Embryotoxicity and teratogenicity of thalidomide in rats.

The teratogenicity of thalidomide in Wistar rats was investigated after a single maternal intravenous injection during the organogenetic period. Thalidomide was administered at 45 mg/kg in 0.5 ml dimethylformamide (DMF) on day 10, 11, or 12 of the pregnancy. Thalidomide induced skeletal deformities of thoracic ribs and of the spinal column in 33 and 56 percent of the fetuses upon maternal administration of the drug on day 11 or 12, respectively. As compared to the solvent (DMF) control, thalidomide caused two- to three-fold higher skeletally malformed fetuses. Deformities of the eyeball in fetuses (ophthalmorrhexis and microphthalmia) were induced by the maternal administration of the drug on day 10 and 12. The solvent (DMF) failed to induce organ deformities. Thalidomide induced embryotoxicity (as measured by percent dead and resorbed fetuses), at a rate three to eight times higher than the DMF control and represented 11 to 24 percent of dead and resorbed fetuses in thalidomide treated groups as compared to three percent in the DMF control group. Mean fetal weight was significantly reduced after maternal administration of thalidomide on day 11 of pregnancy, as compared to the DMF control. These studies conclude that thalidomide is teratogenic and embryotoxic in rats, when administered intravenously at 45 mg/kg bw.

Abnormalities, Drug-Induced↗
PubMed1997

Extravasation of leukocytes assessed by intravital microscopy: effect of thalidomide.

OBJECTIVE AND DESIGN: Thalidomide is very effective in the treatment of idiopathic aphthous stomatitis, characterized by recurrent focal intramucosal leukocytic vasculitis. The mode of action of thalidomide in this clinical entity may include inhibition of the extravasation of leukocytes. Therefore, we studied the effect of thalidomide on different steps of leukocyte migration by intravital microscopy. MATERIAL: Male Syrian golden hamsters were used. TREATMENT: Leukocyte migration in buccal mucosa of the hamster cheek pouch was elicited by the local application of lipopolysaccharide (LPS, 20 micrograms/ml) or murine tumor necrosis factor-alpha (muTNF-alpha, 10 ng/ml). (+)-Thalidomide (20-200 mg/kg i.p.) was administered 60 min before the local application of LPS or muTNF-alpha. Dexamethasone (2 x 1.0-10 mg/kg i.p.) was administered 18 h and 60 min before topical LPS application. METHODS: The numbers of rolling, firmly adherent and migrating leukocytes were estimated by intravital microscopy up to 165 min after the topical applications of LPS or muTNF-alpha and evaluated by an interactive image analysis software. RESULTS: Thalidomide (20-200 mg/kg i.p.) dose-dependently inhibited LPS-stimulated perivenular leukocyte migration by up to 87 +/- 5% and muTNF-alpha-induced leukocyte migration by up to 78 +/- 4%. Dexamethasone (2 x 1.0-10 mg/kg i.p.) inhibited LPS-stimulated leukocyte migration by up to 85 +/- 13%. (+)-Thalidomide (200 mg/kg i.p.) inhibited LPS-stimulated rolling by 80 +/- 5% and reduced the number of firmly adherent leukocytes by about 40%. Dexamethasone (2 x 10 mg/kg i.p.) did not reduce the number of rolling leukocytes but inhibited leukocyte adherence by 72 +/- 9%. CONCLUSIONS: These results show that (+)-thalidomide predominantly inhibits leukocyte rolling and thus differs from the glucocorticoid dexamethasone. The inhibition of LPS- or muTNF-alpha-induced leukocyte extravasation by thalidomide may account for some of its clinical activities.

Animals↗
PubMed2003

Thalidomide blocking of particle-induced TNFalpha release in vitro.

Tumor necrosis factor-alpha (TNFalpha) and interleukin-6 (IL-6), pleiotropic cytokines with osteotropic activities, are produced by multiple cells in the skeletal tissue, including macrophages and osteoblasts. They are thought to be pivotally involved in pathological bone resorption, such as that seen with aseptic loosening. Thalidomide is reported to have antiinflammatory, immunomodulatory effects in a number of inflammatory diseases. We investigated the effect of thalidomide on titanium (Ti) particle-induced TNFalpha and IL-6 production by both human macrophage U937 and osteoblast MG-63 cell lines. They were stimulated with 1 x 10(7) Ti particles/ml and treated simultaneously with or without various concentrations of thalidomide (from 2.5 ng/ml to 25 microg/ml) for 24, 48, or 72 h. Cell viability and proliferation were measured. TNFalpha and IL-6 in the supernatant of the culture media were also analyzed with an enzyme-linked immunosorbent assay. We found that with a concentration of thalidomide of less than 2.5 microg/ml the viability of the two cell lines did not differ significantly from that of controls treated simultaneously with 1 x 10(7) Ti particles/ml. Cell proliferation was inhibited to some extent when they were treated with thalidomide 2.5 microg/ml co-cultured with 1 x 10(7) Ti particles/ml. Thalidomide treatment was found to inhibit TNFalpha production in a dose-dependent manner in human macrophages exposed to Ti particles. At the clinically achievable drug dose of 2.5 microg/ml, 34.4% TNFalpha inhibition occurs. Thalidomide had no effect on IL-6 secretion in these cultures. These data support the idea that thalidomide may have potential for treating prosthetic loosening in humans.

Cell Line↗
PubMed1989

The effect of thalidomide on experimental autoimmune myasthenia gravis.

Thalidomide is reported to have immunosuppressive and anti-inflammatory effects which have led to its use in the treatment of a number of immune-mediated disorders including leprosy, prurigo, discoid lupus, and Behcet's disease. In addition, thalidomide has recently been used to prevent immunological rejection phenomena following skin and bone-marrow grafts. The immune responses in these conditions are thought to be cell-mediated. However, little is known about the effectiveness of thalidomide in suppressing antibody-mediated immune responses. In the present study, we have examined the effect of thalidomide in a model antibody-mediated autoimmune disorder--experimental autoimmune myasthenia gravis (EAMG). To induce EAMG, Lewis rats were immunized with acetylcholine receptor (AChR) purified from the electric organ of Torpedo californicus. Groups of rats were treated daily, either with thalidomide in excess of doses reported to prevent graft-versus-host (GVH) disease in bone-marrow-transplanted rats, or with control treatments. Our results show that thalidomide failed to inhibit AChR antibody production despite good absorption and high blood levels of the drug. This suggests that thalidomide is not likely to be generally useful in the treatment of antibody-mediated autoimmune conditions. However the selective effect of thalidomide in suppressing certain presumably cellular immune responses, while sparing antibody production, is inherently interesting, and merits further study.

Animals↗
PubMed2006

Thalidomide attenuates the development of fibrosis during post-infarction myocardial remodelling in rats.

BACKGROUND: Inflammation plays a pathogenic role in the development of heart failure (HF). The aim of this study was to examine the effect of treatment with the immunomodulating drug thalidomide in a rat model for post-myocardial infarction (MI) HF. METHODS: Rats were subjected to MI by left coronary artery ligation or sham-operated. Seven days after surgical intervention rats were randomised to treatment with thalidomide or vehicle for 8 weeks. RESULTS: Our main findings were: (i) thalidomide treatment did not affect cardiac function or the hypertrophic response, as determined by haemodynamic measurements and heart chamber weights, respectively. (ii) HF rats treated with thalidomide had a minor reduction in septum and relative wall thickness (p<0.05), indicating an anti-remodelling effect. (iii) Thalidomide appeared to have immunostimulatory effects on the myocardium as evident by increased MIP-1alpha gene expression (p<0.05). (iv) Treating HF rats with thalidomide reduced myocardial collagen content, as assessed by markedly decreased levels of hydroxyproline ( approximately 40% reduction; p<0.05), accompanied by lower TGF-beta(1) gene expression (p<0.05). CONCLUSION: Although thalidomide had no effect on cardiac function, our results suggest that intervention with thalidomide may have beneficial effects in post-MI HF by attenuating collagen accumulation and development of myocardial fibrosis.

Animals↗
PubMed2000

Analgesic effect of thalidomide on inflammatory pain.

Tumor necrosis factor alpha (TNF-alpha) may have a pivotal role in the genesis of mechanical inflammatory hyperalgesia in rats and in the nociceptive writhing response in mice. Thalidomide has been shown to selectively inhibit TNF-alpha production. We therefore investigated the effect of thalidomide on these responses as well as on the hot plate response in mice. Hyperalgesic responses to intraplantar (i.pl.) injections of carrageenin or bradykinin, which act by stimulating TNF-alpha release, but not responses to TNF-alpha or prostaglandin E(2), were inhibited in a dose-dependent manner by pretreatment of the animals with thalidomide. The nociceptive writhing responses induced by intraperitoneal (i.p.) injections of zymosan or acetic acid were also inhibited in a dose-dependent manner by pretreatment of mice with thalidomide. Moreover, the thalidomide pretreatment also reduced the TNF-alpha mRNA levels in the peritoneal cells induced by injection of zymosan in mice. The analgesic effect of thalidomide is not due to a central effect, since the drug had no effect in the hot plate test. The demonstration that thalidomide is able to inhibit inflammatory hyperalgesia in rats and the writhing nociceptive response in mice suggests that these analgesic effects seem to be a consequence of the inhibition of TNF-alpha production, and indicates the need for investigations on the possibility of the use of thalidomide for the treatment of pain refractory to classical non-narcotic analgesics.

Acetates↗
PubMed2001

Therapeutic application of thalidomide in multiple myeloma.

Treatment with thalidomide and dexamethasone was given to 26 patients with active, previously untreated multiple myeloma (MM). Thalidomide was administered in an initial dosage of 200 mg/d for 2 weeks and then increased as tolerated (in 200-mg increments at 2-week intervals) to a maximum daily dose of 800 mg. Dexamethasone was given orally in a dosage of 40 mg/d on days 1 through 4, 9 through 12, and 17 through 20 in odd cycles and 40 mg/d on days 1 through 4 in even cycles at monthly intervals. Response was defined as a decrease in serum and urine monoclonal (M)-protein by 50% or greater. Twenty (77%) of 26 patients with active MM exhibited a therapeutic response. Among the first seven patients treated with a thalidomide dose of 400 mg, grade III to IV skin toxicity developed in two. Drug titration was then stopped and the thalidomide dose maintained at 200 mg/d. Six (86%) of seven patients showed a response after thalidomide dose escalation, whereas 14 (74%) of 19 patients demonstrated a response with a constant thalidomide dose of 200 mg/d. Thalidomide alone produced a response in six (38%) of 16 patients with smoldering or indolent myeloma. The angiogenesis grade was elevated in only 8% of these patients. Thirty-two patients with relapsed myeloma were treated with thalidomide dosed at 200 mg/d, with 200-mg escalations every 2 weeks to a maximum daily dose of 800 mg. Prior chemotherapy had failed and five (16%) patients had experienced relapse following stem cell transplantation. Ten (38%) of the 26 patients who had received at least two cycles of therapy obtained a response.

Angiogenesis Inhibitors↗