Silicosis future or investigational therapies: Difference between revisions

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{{Silicosis}}
{{Silicosis}}
{{CMG}}
{{CMG}} {{AE}} {{AV}}


==Overview==
==Overview==
Silicosis is an irreversible condition with no cure. Treatment options currently focus on alleviating the symptoms and preventing complications.
Silicosis is an irreversible condition. Treatment options currently focus on alleviating the symptoms and preventing complications.
==Future or Investigational Therapies==
==Future or Investigational Therapies==
*Experimental treatments include:
Experimental treatments include
===Systemic glucocorticoid therapy===
*In chronic silicosis with [[COPD]] flare up, [[prednisolone]] has been used and this resulted in statistically (although not clinically) significant improvements in [[lung volumes]], [[carbon monoxide|carbon monoxide diffusing capacity]], and [[partial pressure of arterial oxygen]]<ref name="pmid2008993">{{cite journal| author=Sharma SK, Pande JN, Verma K| title=Effect of prednisolone treatment in chronic silicosis. | journal=Am Rev Respir Dis | year= 1991 | volume= 143 | issue= 4 Pt 1 | pages= 814-21 | pmid=2008993 | doi=10.1164/ajrccm/143.4_Pt_1.814 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2008993  }} </ref>


:*Systemic glucocorticoid therapy :
===Tamoxifen citrate===
::*In chronic silicosis with COPD flare up, prednisolone has been used and this resulted in statistically (although not clinically) significant improvements in lung volumes, carbon monoxide diffusing capacity, and partial pressure of arterial oxygen.<ref name="pmid2008993">{{cite journal| author=Sharma SK, Pande JN, Verma K| title=Effect of prednisolone treatment in chronic silicosis. | journal=Am Rev Respir Dis | year= 1991 | volume= 143 | issue= 4 Pt 1 | pages= 814-21 | pmid=2008993 | doi=10.1164/ajrccm/143.4_Pt_1.814 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2008993 }} </ref>
*[[Tamoxifen citrate]], a [[selective estrogen receptor modulator]] used for the treatment of [[breast cancer]] , inhibits the production of [[TGF-β|transforming growth factor-beta]] ([[TGF-β]]). TGF-β has important roles in the formation of [[fibrosis]] such as the modulation of inflammation, wound repair, and immunity by decreasing lymphocyte proliferation and encouraging growth of [[fibroblasts]]. Studies about the possible effects of [[tamoxifen]] on progression, prevention, and treatment of the fibrotic pulmonary silicosis disease considering the anti-fibrotic effect shown in aforementioned studies<ref name="pmid25218282">{{cite journal| author=Yoldas O, Karaca T, Bilgin BC, Yilmaz OH, Simsek GG, Alici IO et al.| title=Tamoxifen citrate: a glimmer of hope for silicosis. | journal=J Surg Res | year= 2015 | volume= 193 | issue= 1 | pages= 429-34 | pmid=25218282 | doi=10.1016/j.jss.2014.08.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25218282 }} </ref>


===Whole-lung lavage===


 
*[[Bronchoalveolar lavage|Whole-lung lavage]] can be done based on the similarity of acute silicosis and [[pulmonary alveolar proteinosis]], although clinical utility is not very clear<ref name="pmid23632425">{{cite journal| author=Stafford M, Cappa A, Weyant M, Lara A, Ellis J, Weitzel NS et al.| title=Treatment of acute silicoproteinosis by whole-lung lavage. | journal=Semin Cardiothorac Vasc Anesth | year= 2013 | volume= 17 | issue= 2 | pages= 152-9 | pmid=23632425 | doi=10.1177/1089253213486524 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23632425  }} </ref>
 
 
 
* Whole-lung lavage (see [[Bronchoalveolar lavage]])
* Inhalation of powdered aluminium, d-penicillamine and polyvinyl pyridine-N-oxide.
* [[Corticosteroid]] therapy.
* The herbal extract tetrandine may slow progression of silicosis.<ref>{{cite paper
  | author =Chao, D.H. ; Ma, J.Y.C. ; Malanga, C.J. ; Banks, D.E. ; Hubbs, A.F. ; Rojanasakul, Y. ; Castranova, V. ; Ma, J.K.H
  | title =Multiple emulsion-mediated enhancement of the therapeutic effect of tetrandine against silicosis
  | version =
  | publisher =West Virginia University School of Pharmacy
  | date =July 1996
  | url =http://www.osti.gov/energycitations/product.biblio.jsp?osti_id=463739
  | format =
  | accessdate =  
  | quote = Previously it was shown that the action of tetrandrine is attributed to its ability to inhibit the release of reactive oxygen metabolites and inflammatory cytokines by alveolar macrophages, and that targeted delivery of tetrandrine to alveolar macrophages using a multiple emulsion system minimizes drug toxicity, maintains the drug's pharmacological activity, and enhances tetrandrine distribution in the lungs while reducing systemic drug distribution. This study provides ''in vivo'' evidence of emulsion-mediated enhancement of drug action in the lungs against silica-induced lung injury using a rat model. }}</ref>


==References==
==References==

Latest revision as of 13:41, 24 June 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aparna Vuppala, M.B.B.S. [2]

Overview

Silicosis is an irreversible condition. Treatment options currently focus on alleviating the symptoms and preventing complications.

Future or Investigational Therapies

Experimental treatments include

Systemic glucocorticoid therapy

Tamoxifen citrate

Whole-lung lavage

References

  1. Sharma SK, Pande JN, Verma K (1991). "Effect of prednisolone treatment in chronic silicosis". Am Rev Respir Dis. 143 (4 Pt 1): 814–21. doi:10.1164/ajrccm/143.4_Pt_1.814. PMID 2008993.
  2. Yoldas O, Karaca T, Bilgin BC, Yilmaz OH, Simsek GG, Alici IO; et al. (2015). "Tamoxifen citrate: a glimmer of hope for silicosis". J Surg Res. 193 (1): 429–34. doi:10.1016/j.jss.2014.08.013. PMID 25218282.
  3. Stafford M, Cappa A, Weyant M, Lara A, Ellis J, Weitzel NS; et al. (2013). "Treatment of acute silicoproteinosis by whole-lung lavage". Semin Cardiothorac Vasc Anesth. 17 (2): 152–9. doi:10.1177/1089253213486524. PMID 23632425.

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