In vitro effect of indomethacin and interferon-alpha on Th1 and Th2 cytokine synthesis in patients with chronic hepatitis C

Current evidences suggest that non-steroidal anti-inflammatory drugs could enhance the antiviral activity of interferon-\u3b1 in chronic HCV infection. In this study, we investigated the effect of indomethacin, a non-steroidal anti-inflammatory drug, and interferon-\u3b1 on cytokine production by peripheral blood mononuclear cells from 12 untreated patients with chronic hepatitis C. We evaluated the effect of incubation with indomethacin, interferon-\u3b1 or both on synthesis of Th1- (interleukin-2, interferon-\u3b3) and Th2-associated cytokines (interleukin-4, interleukin-10), and of the antiviral protein 2\u2032,5\u2032-oligoadenylate synthetase. Interferon-\u3b1 induced a significant increase in production of interleukin-2. Smaller increases were also seen in the presence of indomethacin, while incubation with both indomethacin and interferon-\u3b1 leads to a synergistic effect. Incubation with indomethacin decreased both interleukin-4 and interleukin-10, whereas interferon-\u3b1 increased these cytokines. The addition of indomethacin to interferon-\u3b1 significantly reversed this interferon-induced increase. Finally, both indomethacin and the association interferon-\u3b1 plus indomethacin determined a significant increase in 2\u2032,5\u2032-oligoadenylate synthetase production compared to both baseline and interferon-\u3b1 alone. In conclusion, indomethacin was able to enhance the antiviral activity of interferon-\u3b1 and to modulate the interferon-induced Th1 and Th2 cytokine response by increasing the Th1-response, fundamental for sustained clearance of HCV, and by decreasing the Th-2 type response, associated with HCV persistenc

In vitro effect of indomethacin and interferon-alpha on Th1 and Th2 cytokine synthesis in patients with chronic hepatitis C

Current evidences suggest that non-steroidal anti-inflammatory drugs could enhance the antiviral activity of interferon-\u3b1 in chronic HCV infection. In this study, we investigated the effect of indomethacin, a non-steroidal anti-inflammatory drug, and interferon-\u3b1 on cytokine production by peripheral blood mononuclear cells from 12 untreated patients with chronic hepatitis C. We evaluated the effect of incubation with indomethacin, interferon-\u3b1 or both on synthesis of Th1- (interleukin-2, interferon-\u3b3) and Th2-associated cytokines (interleukin-4, interleukin-10), and of the antiviral protein 2\u2032,5\u2032-oligoadenylate synthetase. Interferon-\u3b1 induced a significant increase in production of interleukin-2. Smaller increases were also seen in the presence of indomethacin, while incubation with both indomethacin and interferon-\u3b1 leads to a synergistic effect. Incubation with indomethacin decreased both interleukin-4 and interleukin-10, whereas interferon-\u3b1 increased these cytokines. The addition of indomethacin to interferon-\u3b1 significantly reversed this interferon-induced increase. Finally, both indomethacin and the association interferon-\u3b1 plus indomethacin determined a significant increase in 2\u2032,5\u2032-oligoadenylate synthetase production compared to both baseline and interferon-\u3b1 alone. In conclusion, indomethacin was able to enhance the antiviral activity of interferon-\u3b1 and to modulate the interferon-induced Th1 and Th2 cytokine response by increasing the Th1-response, fundamental for sustained clearance of HCV, and by decreasing the Th-2 type response, associated with HCV persistenc

Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care

<p>Abstract</p> <p>Background</p> <p>To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings.</p> <p>Methods</p> <p>An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders.</p> <p>Results</p> <p>From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cut-off of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at self-report. Stability in the number of symptoms after 6 months was good (k = 0.57).</p> <p>Conclusions</p> <p>The 29 symptoms version of the SOMS-2 with a cut-off of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.</p