Immunomodulatory function of the 5-HT3 receptor antagonist tropisetron.
OBJECTIVE
To characterize the immune modulatory effects of 5-HT3 receptor antagonist treatment in patients with fibromyalgia, autoimmune disorders, and chronic pain.


METHODS
Multiplex-assisted cytokine measurements were performed before and during treatment. Whole blood stimulation with TNF-alpha was carried out to determine the proinflammatory response induced by exogenous TNF-alpha.


RESULTS
Five of nine patients clinically responded to treatment, and two had a moderate response. All patients had significantly elevated levels of T-H1 cytokines more prominent than TNF-alpha, IL-1beta, and IL-6. Treatment resulted in transient effects on peripheral monocyte counts in all but one patient, a plasma IL-1beta increase in two responder patients, and decreased T-H1 cytokines in two responder patients. Ex vivo TNF-alpha stimulation was transiently reconstituted in three responder patients to a significant level. Three patients showed a marginal reconstitutive response.


CONCLUSIONS
5-HT3 receptor blockade transiently affects monocyte tissue infiltration, modulates T-H1 cytokines in clinical responders as well as MIP-1beta in moderate responders, and transiently affects the ex vivo response to exogenous TNF-alpha.
Schneider
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EM
Section of Experimental Anesthesiology, University Clinic Ulm, Ulm, Germany. marion.schneider@medizin.uni-ulm.de
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Stratz
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Müller
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Lorenz
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Seeling
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D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy; D002908:Chronic Disease; D005356:Fibromyalgia / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007211:Indoles / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D000077526:Tropisetron
D007211:Indoles; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; D000077526:Tropisetron