Effects of carbamazepine and metabolites on IL-2, IL-5, IL-6, IL-10 and IFN-γ secretion in epileptic patients: the influence of co-medication.
Journal Title: Pharmacological Reports - Year 2011, Vol 63, Issue 1
Abstract
Carbamazepine is a widely used anticonvulsive agent. Its metabolic pathway leads not only to the major active metabolite, carbamazepine-10,11-epoxide, but also to minor terminal metabolites such as iminostilbene and acridine. Carbamazepine is usually well-tolerated, but it may lead to rare, but serious, hypersensitive reactions associated with hypereosinophilia. The mechanisms of hypersensitivity reactions to carbamazepine are still largely unknown, and the implications of the cell-mediated immune response (Th1 pathway) or the humoral immune response (Th2 pathway) are still not understood in these reactions. It is also unclear whether the parent drug or its subsequent metabolites are the primary trigger agent. In our study, we performed ex vivo experiments to evaluate the stimulation of cytokine secretion by carbamazepine, carbamazepine-10,11-epoxide, iminostilbene and acridine. IL-5, IL-6 and IL-10 were quantified as markers of the Th2 pathway, and IL-2 and IFN-γ were used as markers of the Th1 pathway. Blood samples (n=24) were obtained from epileptic patients routinely treated with carbamazepine alone or co-treated with lamotrigine or valproate. The concentrations of cytokines in the plasma were determined before and after 3 h stimulation with drugs. We found a significantly positive effect of co-treatment with valproate on the basal level of IL-5 (p<0.01) and IL-10 (p<0.05). IL-5 production increased only in blood stimulated with a high level of acridine (33 μM), whereas IL-6 production was less specifically stimulated (p<0.05). Because IL-5 is the most potent stimulating factor of the eosinophils, we suggest that the potential helper effect of valproate and acridine can lead to hypersensitive reactions to carbamazepine in the context of the humoral immune response.
Authors and Affiliations
Olivier Mathieu, Marie-Christine Picot, Philippe Gelisse, Hélène Breton, Pascal Demoly, Dominique Hillaire-Buys
Keywords
Related Articles
- EP ID EP129499
- DOI -
- Views 91
- Downloads 0
Dose-depending effect of intracerebroventricularly administered bradykinin on nociception in rats.
The effect of small and high doses of intracerebroventricularly (icv) applied bradykinin (BK) on nociception produced by mechanical stimuli and the participation of B1 and B2 receptors in this nociception were investigat...
Application of magnetic resonance diffusion anisotropy imaging for the assessment neuroprotecting effects of MPEP, a selective mGluR5 antagonist, on the rat spinal cord injury in vivo.
Magnetic resonance diffusion anisotropy imaging (DAI) of the rat spinal cord after contusion using weight-drop method was used to study the neuroprotecting effect of 2-methyl-6-(phenylethynyl)-pyridine (MPEP), an mGluR5...
Ezetimibe - a new approach in hypercholesterolemia management.
Frequencies and roles of CYP3A5, CYP3A4 and ABCB1 single nucleotide polymorphisms in Italian teenagers after kidney transplantation.
The main genes involved in the pharmacokinetics of immunosuppressive drugs are those encoding cytochrome P450 (CYP) family enzymes and multidrug resistance 1 (ABCB1). In this study, 87 Italian teenagers with transplanted...
Modulatory effect of sildenafil in diabetes and electroconvulsive shock-induced cognitive dysfunction in rats.
The nitric oxide/guanylyl cyclase, cyclic guanosine monophosphate/phosphodiesterase 5 (NO/cGMP/PDE5) pathways play a key role in physiological and pathological situations, such as synaptic plasticity, learning and memory...