Intermittent rifampicin treatment in experimental tuberculosis.
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Biomedical subjects
Publications and source records attributed to A Petre.
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Favourable results were obtained by treatment with Reprimun alone or in association with low doses of Prednisone in 112 patients with sarcoidosis (59% with active sarcoidosis and 33% failures of a previous corticotherapy). Treatments were applied during 3-6 series each one of 6 weeks at intervals of 2 weeks between series. In comparison with the classical corticotherapy, treatment with Reprimun has better results, namely: absence of any major adverse reactions; reduction of the treatment period to 6-12 months (3-6 series); 95% lasting remissions in the sarcoidoses with initial treatment and 78% remissions in the case of failures of a previous corticotherapy.
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Seven patients with advanced forms of mediastino-pulmonary sarcoidosis (involvement of the pulmonary parenchyma, and restrictive respiratory syndrome), confirmed by histopathologic investigation, have been treated with a new SV-rifamycin derivative, 1246-EH, or "Reprimum" without any other association. Reprimun was given in daily doses of 10 mg/kg of body weight for a period of two weeks, then, for another 4-5 weeks, the drugs was given intermittently in doses of 15 mg/kg of body weight twice weekly. Between two cycles of therapy a period of 14 days was free of drug administration. In all patients the treatment with the new derivative was well tolerated. The treatment was not followed by adrenal deficiencies, neither was noted obesity, bone decalcification, gastric ulcers, etc., which are commonly associated with prolonged corticoid therapy. The treatment with "Reprimun" efficient for all patients. A clear clinical and X-ray improvement was noted after the first three months of treatment with the new drug. Respiratory function, as well as clinical and radiological signs improved, the serum immunologic parameters, and the biochemical ones were also significantly improved (Ig, C3 total serum proteins and gammaglobulins). All parameters which were tested were finally improved and became normal. In only two of the seven patients the radiological aspects of the lung suggested the presence of sequellae at the end of the treatment. In these two patients there was a persistant reduction in the respiratory volume, as well as a discret hypoxemia. However, both these patients had a more advanced form of the disease, with extensive pulmonary fibrosis, and in these cases prolonged corticoid therapy which had previously been applied had failed. Reprimun had an immunological-modulatory effect in all patients, resulting in normal levels of IgG, IgA, and C3 in the first three months of therapy. There was a direct correlation between the normalization of immunological indicators and the good evolution of the diseases, a fact which suggests once again the existence of some immune mechanisms involved in the maintenance of sarcoidosis.
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The study concerns 264 cases among which: 119 active lung tb. eliminating and 11 cases not-eliminating M. Tuberculosis; 17 cases of extrarespiratory tb. confirmed by bacteriology and/or by anatomopathology; 18 cases of bone-joint non-tb disease; 38 cases of chronic lung disease other than tb; 61 healthy persons (controls). Sera from these cases were collected before treatment and submitted concomitantly to two different methods: (1) Mycodot test (immunoblot) with lipoarabinomannan (LAM) as antigen, on nitrocellulose discs (Dynagen, Cambridge, MA, USA); (2) ELISA test with antigen 60 (A60) (ANDA-Biologicals, Strasbourg, France) and with antigen I.C. (Cantacuzino Institute, Bucharest). The results were estimated on terms of sensitivity and specificity. As for sensitivity the results show 74-90%. the highest values were reached in ELISA with A60 IgA. The specificity of the Mycodot test was highest: 90-100% in the two successive experiments. The active tb diagnosis discrimination capacity of the studied methods allows the following classification: 1. Mycodot test with LAM antigen 2. ELISA with A60-Ig G complex 3. ELISA with I.C. antigen The Mycodot test is more advantageous being more rapid and more simple to perform.