title: Low doses of dexamethasone constantly delivered by autologous erythrocytes slow the progression of lung disease in cystic fibrosis patients.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of the administration of low doses of glucocorticoids in patients with cystic fibrosis (CF) by using autologous erythrocytes loaded with dexamethasone 21-phosphate.
  
  
  METHODS
  Nine consecutive CF patients (patients nos. 1-9) received autologous erythrocytes loaded with increasing amounts of dexamethasone 21-phosphate to obtain a slow delivery of dexamethasone in circulation. The appearance of possible adverse effects, the reproducibility of the procedure, and the dexamethasone pharmacokinetics were evaluated. Subsequently, patient no. 9 and eight additional patients (patient nos. 10-17) received dexamethasone 21-phosphate-loaded erythrocytes at 1-month intervals to evaluate the efficacy of continuous release in circulation of low doses of dexamethasone.
  
  
  RESULTS
  Erythrocytes from CF patients can be processed to be loaded with increasing dexamethasone 21-P concentrations. Once reinfused in respective donors, a slow and prolonged delivery of dexamethasone in the blood stream was measured up to 28 days. Repeated administrations of drug-loaded erythrocytes at 4-week intervals for 15 months showed that very low doses of glucocorticoids provide significant improvement in FEV1 values and significant reduction of infective relapses due to Pseudomonas aeruginosa without adverse effects.
  
  
  CONCLUSIONS
  The administration of very low doses of glucocorticoids using autologous erythrocytes is possible, with benefits for patients and without side effects. This method is likely to be extended to other chronic diseases.
authors.affiliation: Institute of Biological Chemistry G. Fornaini, University of Urbino, 61029 Urbino, Italy.
authors.forename: Luigia
authors.initials: L
authors.lastname: Rossi
authors.forename: Massimo
authors.initials: M
authors.lastname: Castro
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Orio
authors.forename: Gianluca
authors.initials: G
authors.lastname: Damonte
authors.forename: Sonja
authors.initials: S
authors.lastname: Serafini
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bigi
authors.forename: Ivo
authors.initials: I
authors.lastname: Panzani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Novelli
authors.forename: Bruno
authors.initials: B
authors.lastname: Dallapiccola
authors.forename: Simona
authors.initials: S
authors.lastname: Panunzi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Di Carlo
authors.forename: Sergio
authors.initials: S
authors.lastname: Bella
authors.forename: Mauro
authors.initials: M
authors.lastname: Magnani
mesh_terms: D000293:Adolescent; D000328:Adult; D001804:Blood Transfusion, Autologous; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000628:therapy*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D018450:Disease Progression; D017707:Erythrocyte Transfusion / Q000379:methods*; D004912:Erythrocytes / Q000378:metabolism; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D011552:Pseudomonas Infections / Q000209:etiology / Q000628:therapy; D011550:Pseudomonas aeruginosa; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: C004180:dexamethasone 21-phosphate; D003907:Dexamethasone