LETTER
Immunosuppressive Effect of Zidovudine
Raphael B. Strickler and
Blaine F. Elswood
1 April 1993 | Volume 118 Issue 7 | Pages 571-572
TO THE EDITOR:
We would like to emphasize one point in the excellent review on zidovudine by McLeod and Hammer [1]; that is, at "clinically relevant" concentrations, zidovudine has been shown to diminish responsiveness of peripheral blood mononuclear cells to mitogens and to inhibit immune cell growth in vitro [2]. This antiproliferative effect of zidovudine resembles that of corticosteroids or immunosuppressive agents and suggests an immunosuppressive or anti-inflammatory role for the drug.
As they noted, zidovudine therapy may have a beneficial effect on human immunodeficiency virus (HIV)-related immune thrombocytopenic purpura [3], HIV-associated leukoencephalopathy [4], and HIV-induced psoriasis [5]. The possibility that these autoimmune and inflammatory conditions are responding to the immunomodulatory action of zidovudine rather than to its antiviral properties should be considered.
1. McLeod GX, Hammer SM. Zidovudine: five years later. Ann Intern Med. 1992; 117:487-501.
2. Heagy W, Crumpacker C, Lopez PA, Finberg RW. Inhibition of immune function by antiviral drugs. J Clin Invest. 1991; 87:1916-24.
3. Stricker RB. Hemostatic abnormalities in HIV disease. Hematol Oncol Clin NA. 1991; 5:249-65.
4. Conway B, Halliday WC, Brunham RC. Human immunodeficiency virus-associated progressive multifocal leukoencephalopathy: apparent response to 3'-azido-3'-deoxythymidine. Rev Infect Dis. 1990; 12: 479-82.
5. Kaplan MH, Sadick NS, Weider J, Farber BF, Neidt GW. Anti-psoriatic effects of zidovudine in human immunodeficiency virus-associated psoriasis. J Am Acad Dermatol. 1989; 20:76-82.
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