Thalidomide in the treatment of chronic hepatitis C unresponsive to alfa-interferon and ribavirin

Laura Milazzo, Mara Biasin, Nadia Gatti, Luca Piacentini, Fosca Niero, Barbara Zanone Poma, Massimo Galli, Mauro Moroni, Mario Clerici, Agostino Riva

Research output: Contribution to journalArticlepeer-review

Abstract

Immunomodulation of thalidomide is represented by the antiinflammatory effect through inhibition of tumor necrosis factor α and costimulatory effect on human CD8+ T cells. We investigated the efficacy and safety of a 24-wk course of thalidomide at a dosage of 200 mg/day in eight patients with HCV chronic hepatitis nonresponders to interferon α plus ribavirin. We observed a significant mean decrease of serum aminotransferases and γ-glutamyltransferases of 39% and 61%, respectively (p= 0.017 and 0.02). Tumor necrosis factor-αin vitro production in mononuclear cells decreased with thalidomide in all the subjects (p= 0.028). Perforin- and granzyme-specific mRNA expression increased under thalidomide without statistical significance. A positive correlation between biochemical and immunological parameters was observed with higher increase of granzyme and perforin values in patients showing reduction of aminotransferases. Finally upregulation of T-helper 1 cytokine expression as mean interferon γ/IL-10 ratio was evidenced. Thalidomide was well tolerated. In conclusion, thalidomide was able to reduce liver enzymes in six out of eight patients with chronic hepatitis C and to reduce tumor necrosis factor α production, representing a promising new approach for the treatment of HCV infection.

Original languageEnglish
Pages (from-to)399-402
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume101
Issue number2
DOIs
Publication statusPublished - Feb 2006

ASJC Scopus subject areas

  • Gastroenterology

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