The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE.
Hydroxychloroquine has several less well-known actions that may have clinical relevance in treating systemic lupus erythematosus (SLE). (1) Hydroxychloroquine has a possible anti-thrombotic action. It is a platelet inhibitor and appears to decrease the risk of thromboembolism in patients with anticardiolipin antibodies. (2) Hydroxychloroquine is associated with lower serum cholesterol and low-density lipoprotein levels compared to those present in patients who are taking corticosteroids but not antimalarials for SLE. (3) It may also decrease abnormal levels of cytokines. Interleukin-6 (IL-6), soluble CD8 and soluble IL-2 receptors (sIL-2R) are lower in patients taking antimalarials compared to those on corticosteroids alone or on neither medication. Serum levels of CD8 and sIL-2R decrease after 6 weeks of hydroxychloroquine treatment. These findings may help explain the favorable response of SLE patients treated with antimalarials.
Wallace
D J
DJ
Cedars-Sinai Medical Center, Los Angeles.
Linker-Israeli
M
M
Metzger
A L
AL
Stecher
V J
VJ
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D016827:CD8 Antigens / Q000097:blood; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D015375:Receptors, Interleukin-2 / Q000378:metabolism; D013923:Thromboembolism / Q000517:prevention & control
D000962:Antimalarials; D016827:CD8 Antigens; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D006886:Hydroxychloroquine