Author/Authors :
Mohammadpour, Amir-Hooshang mashhad university of medical sciences - School of Pharmacy - Department of Pharmacodynamics and Toxicology, ايران , Nazemian, Fatemeh mashhad university of medical sciences - Imam Reza Hospital - Department of Internal Medicine, Nephrology Ward, ايران , Hassanzade Khaiat, Mohammad mashhad university of medical sciences - School of Pharmacy - Department of Medicinal Chemistry, ايران , Tafaghodi, Mohsen mashhad university of medical sciences - School of Pharmacy - Department of Pharmaceutics, ايران , Salari, Pooneh Tehran University of Medical Sciences - Medical Ethics and History of Medicine Research Center, ايران , Charkazi, Somaieh mashhad university of medical sciences - School of Pharmacy - Department of Pharmacodynamics and Toxicology, ايران , Naghibi, Masih mashhad university of medical sciences - Imam Reza Hospital - Department of Internal Medicine, Nephrology Ward, ايران , Shamsara, Jamal mashhad university of medical sciences - School of Pharmacy, Pharmaceutical Research Center, ايران
Abstract :
Use of recombinant human erythropoietin (rh-Epo) improves hemoglobin (Hgb) in 90-95% of the cases of anemia of chronic kidney disease (CKD). However,it is known that pro-inflammatory cytokines such as interferon-gamma (IFN-γ),tumor necrosis factor-alfa (TNF-α) and interleukin-1 (IL-1) suppress erythropoiesis,resulting in inadequate response to rh-Epo. Pentoxifylline has been shown to have modulatory effects on the immune system. This prospective study to evaluate the effect of pentoxyphylline on erythropoeisis was performed on 15 (eight males,seven females) clinically stable patients who had been on hemodialysis for at least six months with anemia (Hgb of 10.7 g/dL) unresponsive to rh-Epo despite high doses. They were treated with 400 mg pentoxifylline tablets once daily for 12 weeks. Hgb increased after one and two months of drug administration,but significant changes were observed in eight (53%) patients after three months (P 0.05). Our study illustrates a probable new use for an old medicine. Three months treatment with pentoxifylline was seen to increase Hgb significantly in rh-Epo-resistant patients. More prospective studies with a larger sample size are needed to determine the inhibitory role of cytokines on hematopoiesis and exploring new drugs or new drug indications to overcome anemia in advanced renal failure.
