HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

Electronic Letters to:

reviews: Claudia Steurer-Stey, Lucas M. Bachmann, Johann Steurer, and Martin R. Tramèr Oral Purified Bacterial Extracts in Chronic Bronchitis and COPD: Systematic Review Chest 2004; 126: 1645-1655 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Immunostimulants for chronic bronchitis/COPD

Blanca Del-Rio-Navarro, Alberto J Escalante-Dominguez   (25 November 2004)

Immunostimulants for chronic bronchitis/COPD 25 November 2004
Blanca Del-Rio-Navarro, medical doctor Allergy Department Hospital Infantil de México Federico Gómez, Alberto J Escalante-Dominguez Send letter to journal: Re: Immunostimulants for chronic bronchitis/COPD blancadelrio{at}yahoo.com.mx Blanca Del-Rio-Navarro, et al.	To the editor: We have read with great interest the paper on the use of immunostimulant bacterial extract in the prevention of exacerbations of chronic bronchitis and COPD (1). Bacterial extracts are not the only products use as immunostimulants for chronic bronchitis. Other immunostimulants with this indication are pidotimod (synthetic immunostimulant) (2), D53 (bacterial ribosomes and membranes) (3), and RU 41740 (klebsiella lipopolysacharide and glycoprotein) (4). In fact, there is an early metaanalysis on the use of RU 41740 (formerly known as C 1740) in chronic bronchitis (5). In the metaanalysis (1), the primary outcome measure was the prevention of exacerbation as dichotomus data. We consider that the number of exacerbations (as mean and standard deviation) would be a better measure (scalar data), but we recognized that it is not frequently reported in the immunostimulant trials (6). According to clinical trials on children immunostimulants are not able to prevent all the episodes of respiratory infection but they significantly decrease the risk of suffer => 3 infections in six months (7, 8), so, it would be convenient to explore the relative risk of suffer => 2, => 3 exacerbations in the chronic bronchitis trials and metaanalysis. We consider that this systemic review it is important as immunostimulant use is not frequently cited in American journals and it could be the basis for guidelines on immunostimulant trials for chronic bronchitis/COPD. 1.- Steurer-Stey C, Bachmann LM, Steurer J, et al. Oral Purified Bacterial Extracts in Chronic Bronchitis and COPD: Systematic Review. Chest 2004; 126: 1645-1655. 2.- Ciaccia A. Pidotimod activity against chronic bronchitis exacerbations. Arzneimittelforschung 1994; 44: 1516-1520 3.- Borisova AM, Khoroshilova NV, Pinegin BV, et al. The clinico- immunological evaluation of the ribomunyl treatment of chronic bronchitis patients. Ter Arkh 1994; 66: 46-50 4.- Fietta AM, Merlini C, Uccelli M, et al. Immunological and clinical effect of long-term oral treatment with RU 41740 in patients with chronic bronchitis: double-blind trial long-term versus standard dose regimen. Respiration 1992; 59: 253-258 5.- Dahan R, Costantini D, Caulin C, et al. Clinical trials with C 1740, an immunomodulator compound proposed for prevention of acute infectious exacerbations in chronic bronchitis. Methods Find Exp Clin Pharmacol 1986; 8: 41-43. 6.- Berber A, Del-Rio-Navarro B. Compilation and meta-analysis of randomized placebo-controlled clinical trials on the prevention of respiratory tract infections in children using immunostimulants. J Investig Allergol Clin Immunol 2001; 11: 235-246. 7.- Jara-Perez JV, Berber A. Primary prevention of acute respiratory tract infections in children using a bacterial immunostimulant: a double- masked, placebo-controlled clinical trial. Clin Ther 2000; 22: 748-759. 8.- Gutierrez-Tarango MD, Berber A. Safety and efficacy of two courses of OM-85 BV in the prevention of respiratory tract infections in children during 12 months. Chest 2001; 119: 1742-1748.