Old drug, new tricks: haloperidol inhibits secretion of proinflammatory cytokines.
OBJECTIVE
It was noted that treatment of a patient with acute mania by haloperidol was associated with marked improvement in activity of rheumatoid arthritis. The objective of this study was to examine the effects of haloperidol on inflammatory cytokine release in vitro, as a potential mechanism to explain the in vivo anti-inflammatory effects of haloperidol.


METHODS
The effect of haloperidol on the production of inflammatory cytokines interleukin 1beta (IL1beta) and tumour necrosis factor alpha (TNFalpha) was measured in bacterial lipopolysaccharide stimulated whole blood cultures and on the promonocyte cell line THP-1, using commercial and in house enzyme linked immunosorbent assays to measure cytokine concentrations.


RESULTS
Haloperidol inhibited lipopolysaccharide stimulated production of both IL1beta and TNFalpha in vitro in a dose dependent manner and over a prolonged time period. Marked inhibition was seen over a range of concentrations of haloperidol from 0.5 microgram/ml to 50 microgram/ml, including those predicted to occur in the patient's blood.


CONCLUSIONS
Haloperidol treatment seemed to alleviate inflammation in rheumatoid arthritis. In vitro experiments would suggest that the mechanism is by direct inhibition of proinflammatory cytokine release. This phenomenon requires further investigation and may potentially lead to the development of novel treatment.
Moots
R J
RJ
Rheumatology Research Group, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL.
Al-Saffar
Z
Z
Hutchinson
D
D
Golding
S P
SP
Young
S P
SP
Bacon
P A
PA
McLaughlin
P J
PJ
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D014150:Antipsychotic Agents / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D046508:Culture Techniques; D004305:Dose-Response Relationship, Drug; D005260:Female; D006220:Haloperidol / Q000494:pharmacology*; D006801:Humans; D007375:Interleukin-1 / Q000096:biosynthesis*; D014407:Tumor Cells, Cultured; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000187:drug effects*
D000893:Anti-Inflammatory Agents; D014150:Antipsychotic Agents; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D006220:Haloperidol