Low doses of dexamethasone constantly delivered by autologous erythrocytes slow the progression of lung disease in cystic fibrosis patients.

Abstract

OBJECTIVE:

To evaluate the safety and efficacy of the administration of low doses of glucocorticoids in patients with cystic fibrosis (CF) by using autologous erythrocytes loaded with dexamethasone 21-phosphate.

STUDY DESIGN:

Nine consecutive CF patients (patients nos. 1-9) received autologous erythrocytes loaded with increasing amounts of dexamethasone 21-phosphate to obtain a slow delivery of dexamethasone in circulation. The appearance of possible adverse effects, the reproducibility of the procedure, and the dexamethasone pharmacokinetics were evaluated. Subsequently, patient no. 9 and eight additional patients (patient nos. 10-17) received dexamethasone 21-phosphate-loaded erythrocytes at 1-month intervals to evaluate the efficacy of continuous release in circulation of low doses of dexamethasone.

RESULTS:

Erythrocytes from CF patients can be processed to be loaded with increasing dexamethasone 21-P concentrations. Once reinfused in respective donors, a slow and prolonged delivery of dexamethasone in the blood stream was measured up to 28 days. Repeated administrations of drug-loaded erythrocytes at 4-week intervals for 15 months showed that very low doses of glucocorticoids provide significant improvement in FEV1 values and significant reduction of infective relapses due to Pseudomonas aeruginosa without adverse effects.

CONCLUSIONS:

The administration of very low doses of glucocorticoids using autologous erythrocytes is possible, with benefits for patients and without side effects. This method is likely to be extended to other chronic diseases.

• Authors: Luigia Rossi, Massimo Castro, Francesco D'Orio, Gianluca Damonte, Sonja Serafini, Leonardo Bigi, Ivo Panzani, Giuseppe Novelli, Bruno Dallapiccola, Simona Panunzi, Pierluigi Di Carlo, Sergio Bella, Mauro Magnani
• Journal: Blood cells, molecules & diseases (Blood Cells Mol Dis) 2004 Jul-Aug Vol. 33 Issue 1 Pg. 57-63 ISSN: 1079-9796 [Print] United States
• PMID: 15223012 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• dexamethasone 21-phosphate
• Dexamethasone

Topics

• Adolescent
• Adult
• Blood Transfusion, Autologous
• Child
• Cystic Fibrosis (complications, therapy)
• Dexamethasone (administration & dosage, analogs & derivatives, pharmacokinetics)
• Disease Progression
• Erythrocyte Transfusion (methods)
• Erythrocytes (metabolism)
• Humans
• Lung Diseases (etiology, prevention & control, therapy)
• Pseudomonas Infections (etiology, therapy)
• Pseudomonas aeruginosa
• Secondary Prevention
• Treatment Outcome