Biotecnologia Aplicada Elfos Scientiae ISSN: 0684-4551 Vol. 12, Num. 3, 1995, pp. 191-192

REPORTE CORTO/SHORT REPORT

INTERFERON ALPHA-2B AND HYDROXOCOBALAMINE IN EPIDEMIC NEUROPATHY

Francisco Hernandez^1, Violeta Labarta1, Raul Valdes^1, Vivian Saez^1, Alain Morlans^1, Santiago Luis^2, Alfredo Espinosa^3, Jose Cabrera^3, Gerardo Alvarez^4, Jose Diaz^5, Fermin Casales^6 and Pedro Lopez-Saura^1.

^1Center for Genertic Engineering and Biotechnology, P.O. Box 6162, La Habana 6, Cuba. ^2Institute of Neurology and Neurosurgery, Havana. ^3"Gustavo Aldereguia" Provincial Hospital, Cienfuegos. ^4Villa Clara Provincial Hospital, Santa Clara. ^5"Camilo Cienfuegos" Provincial Hospital, Sancti Spiritus. ^6"Manuel Ascunce" Provincial Hospital, Camaguey.

Code Number: BA95083
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More than 40 000 cases of an epidemic neuropathy were reported in Cuba during 1993. Trial tested the combination of IFN alpha-2b and hydroxocobalamine. The rationale of its use in the epidemic neuropathy is based on the toxic hypothesis of the origin of the disease.

INTRODUCTION

More than 40 000 cases of an epidemic neuropathy were reported in Cuba during 1993. It had 2 clinical pictures: an optic neuritis and a peripheral neuropathy (1).

Trial tested the combination of IFN alpha-2b and hydroxocobalamine. This agent is the active form of vitamin B12. It takes cyanide residues and forms cyanocobalamin, playing thus an important role in the cyanide-detoxifying mechanism. The rationale of its use in the epidemic neuropathy is based on the toxic hypothesis of the origin of the disease.

METHODS

Trial was controlled and randomized. Patients older than 15 years, less than 90 days sicks, who had not taken any specific treatment for their neuropathy (except for vitamins) and gave their consent for participation, were eligible for the trial. Patients could have ophtalmologic symptoms, peripheral neuropathy, or both.

The effect of the combination was compared to each of the treatments alone and to the general control. Groups A received the basal vitamin therapy schedule (BVT); Group C received BVT and IFN alpha-2b, 3 x 106 IU, intramuscularly 3 times per week during 3 weeks. Group F received (BVT) and hydroxocobalamine, 5 000 mg every 5th. day during 15 days; then every 2nd. week during 10 weeks. Group E was the combination. These patients received BVT, and hydroxocobalamine and IFN at the same doses and schedule. This trial ran at 5 hospitals in 5 provinces, mostly from the central part of the island. Patients with both forms of the disease were included.

RESULTS AND DISCUSSION

Group C (3 million IU daily dose) had much better evolution at 21 days in trial with more recoveries and less worsening than in the control group with BVT alones. The difference was strengthened when the analysis was performed not including the mild cases. Interestingly, the effect was not observed in group E, where IFN treatment was combined with hydroxocobalamine. This agent alone (group F) did not produce any effect either.

It cannot be concluded that IFN is beneficial in NE but further trials looking for other doses and schedules should be made.

REFERENCES

1. RAM REZ, A.; R. RODR GUEZ,; A. MARRERO; G. MESA M. A. GALINDO. and L. INIGUEZ, (1993). Neuropatia Epidemica: Breve Resena Epidemiologica. Boletin Epidemiologico del Instituto de Medicina Tropical "Pedro Kouri", Num. Especial 1:1-5.