Immunosuppression for dilated cardiomyopathy
Article Abstract:
Idiopathic dilated cardiomyopathy refers to a disease of the heart muscle that causes blood pressure abnormalities and enlargement of the ventricles, the heart's pumping chambers. The end result of this disease process of unspecific origin can include various problems with the electrical conduction system of the heart, inability to pump the quantity of blood demanded by the body (heart failure), embolism, and finally, death. The incidence of dilated cardiomyopathy has been increasing and 11,000 new cases are reported annually within the US. Although various pharmaceutical approaches have been tried, none have been generally successful. Cardiomyopathy is a condition that appears to be the culmination of a conspiracy of various factors that cause an inflammatory process of the myocardium (heart muscle), including: heredity, pregnancy, alcoholism, infection, and inappropriate antibodies to ATP (adenosine triphosphate; a body energy compound). There is a general sense that an immunologic process is at work, and a recent article in the New England Journal of Medicine explores the value of using an anti-inflammatory drug, prednisone. The drug caused a small, but statistically significant improvement in patients classified as "reactive", but this improvement was short lived. There is a considerable problem not so much with the authors' classification scheme, which was not rigorous, but with their conclusion that prednisone should not be used in connection with this disease is valuable. An ongoing study of the role of immunosuppressive therapy with clearly documented myocarditis, the Myocarditis Treatment Trial, is promising, although the use of such agents can not yet be generally recommended. Treatment of myocarditis with an immunosuppressive drug, which blocks the normal functioning of the immune system, is based on the concept that the disease process in these cases is of an immunological origin.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1989
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A clinical trial of immunosuppressive therapy for myocarditis
Article Abstract:
Immunosuppressive therapy does not appear to help patients with myocarditis following viral infections. Myocarditis is an inflammation of the heart muscle. An autoimmune reaction has been proposed as a possible cause of damage. A group of 111 patients was randomly assigned to one of two different 24-week treatment courses with immunosuppressive drugs or to a control group having only conventional therapy. Immunosuppressive therapy did not improve heart muscle function nor did it improve the odds of survival. Measurements of inflammatory mediators in the blood suggested that a stronger inflammatory response was associated with improved heart function. The exception was an increased T-lymphocyte count, which was associated with increased likelihood of death.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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Chemical immunosuppression in islet transplantation - friend or foe?
Article Abstract:
A study proving that the induction of effective and sustained beta-cell regeneration is a successful therapy for insulin-dependent diabetes mellitus is presented. The research was conducted on an experimental mouse model showing that beta-cell regeneration led to normalization of glucose homeostasis and spontaneously followed the destruction of 70 to 80 percent of beta cells.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2008
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