engleski

Met-enkephalin therapy: Immunomodulation and extention of corticosteroid treatment

Objectives: Met-enkephalin is an ubiquitous pentapeptide that was recently applied in the clinical studies of different autoimmune diseases and tumors (Plotnikoff et al., Clin Immunol Immunopathol, 82:93, 1997 ; Štambuk et al., Uveitis Today, Elsevier, Amserdam, pp 319-322, 1998). Methods and Results: We present the results of Met-enkephalin therapy in 38 patients with autoimmune diseases: uveitis, Behçet's disease, allergic conjunctivitis/rhinitis, optic neuritis, multiple sclerosis, SLE/overlap syndrome, rheumatoid arthritis, Evans syndrome/haemolytic anaemia. Met-enkephalin (Peptid M, LUPEX) was administered s.c. in 2 ml of physiological saline, 0.2 - 0.3 mg/kg 5 times weekly for 4 weeks. Afterwards, the weekly dose was gradually reduced every 4 weeks till 5 mg weekly. During Met-enkephalin treatment beneficial clinical effects and significant reduction in the number and severity of relapses were followed by the modulation of serum IFN, IFN-gamma, phagocyte, NK and lymphocyte functions. The improvement of EDSS, evoked potentials, visual field, MRI and ultrasonographic findings was also observed. Conclusions: Met-enkephalin therapy ranging from 6 months to >3 years induced no toxicity or side-effects, relapses were rare, mild, and in most cases did not require additional steroid therapy, i.e. only the rise of Met-enkephalin dose was sufficient. However, the synergistic action of Met-enkephalin and corticosteroids is discussed considering the fact that it is a part of ACTH precursor molecule (Blalock, Immunol Today 15:504, 1994). It is emphasised that in severe autoimmune diseases parallel administration of Met-enkephalin and corticosteroids enables significant reduction of the steroid dose (to e.g. 2-4 mg dexamethasone daily during relapse).

Met-enkephalin; therapy; immunomodulation; corticosteroid; peptid-M; Lupex

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