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Biomedical subjects

Eric Lewin Altschuler

Publications and source records attributed to Eric Lewin Altschuler.

At least 37 records · Page 2Linked to original sources

Paroxetine for hepatopulmonary syndrome?

Hepatopulmonary syndrome (HPS) is a severe pulmonary sequela which can affect up to 15% of patients with cirrhotic liver disease. There is no treatment for HPS other than liver transplantation. The cause of HPS is incompletely understood, but the pulmonary vasodilation in HPS is thought to be related to increased levels of nitric oxide. We therefore suggest that, the extremely safe and commonly used antidepressant medication paroxetine (Paxil) which is a potent nitric oxide synthase (NOS) inhibitor be considered for use in HPS.

Hepatopulmonary Syndrome↗

Combination of bupropion, paroxetine and quetiapine as adjuvant treatment for multiple myeloma.

Multiple myeloma is a severe plasma dyschrasia with no known treatment or cure, even bone marrow transplantation. Cytokines such as tumor necrosis factor-alpha (TNF) and interleukin-6 (Il-6) are thought to be important trophic factors for the malignant plasma cells. In turn, histamine and nitric oxide are positive regulatory factors for Il-6. Here we note that the safe, approved and commonly used psychiatric medicines bupropion (Wellbutrin), paroxetine (Paxil) and quetiapine (Seroquel) are respectively potent TNF, nitric oxide and histamine antagonists and thus might find some use in treatment of multiple myeloma.

Antineoplastic Combined Chemotherapy Protocols↗

Molecular method to test if Parvovirus B19 is a new virus to the Old World.

Parvovirus B19 (PVB19) is a non-trivial cause of morbidity and mortality in young individuals from diseases such as aplastic anemia and hydrops fetalis. Curiously, given this significant disease burden, the one genetic phenotype known to protect against PVB19 infection--the p red-cell phenotype characterized by the lack on any P group antigens on erythrocytes--is extremely rare with a prevalence of only approximately 1/200,000. One explanation is that PVB19 is a new virus to the Old World. It is pointed out in this paper that recently developed powerful genetic methods can be used to test this proposal. Confirmation that PVB19 is a new virus could shed light on the etiology of rheumatoid arthritis.

Africa↗

Consideration of Rituximab for fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is a severe, progressive disease of the musculoskeletal system. Muscles, tendons and other connective tissues ossify after minor trauma, and patients often become encased in a second immobile skeleton. There is no known cure or treatment for FOP. It has been found that lymphocytes from FOP patients elaborate excess levels of bone morphogenic protein-4 (BMP-4). Given this, it has been suggested that allogenic bone marrow transplantation (BMT) possibly could be a cure for FOP, and drawn attention to a previously unappreciated case of an FOP patient who had successful BMT for aplastic anemia with apparent short- and medium-term arresting of the FOP disease process. However, BMT has non-trivial associated morbidity and mortality. Here, it is noted that if B cells are found to be the lymphocytes responsible for excess BMP-4 production in FOP, use of Rituximab, a monoclonal anti-CD20 antibody which effectively targets B cells, could be a less permanent and less risky treatment alternative for FOP.

Antibodies, Monoclonal↗

Bupropion for Blau syndrome.

Blau syndrome (BS) is an autosomal dominantly inherited disease characterized by granulomas and arthritis. The gene mutated in BS was recently found to be CARD15. Mutations in this gene also occur in about 20% of patients with Crohn's disease (CD), though with different mutations than in the Crohn's patients. We are not aware of any cure or specific treatment for BS. We have found that bupropion is effective for CD, and we now suggest that bupropion be considered for treatment of BS.

Arthritis↗