Clinical utility of the liposteroid therapy: Potential effects on the macrophage activation

Wakiguchi, Hiroyuki; Ohga, Shouichi

doi:10.2177/jsci.39.190

Cited by 11 publications

(9 citation statements)

References 40 publications

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“…Liposteroid [dexamethasone palmitate (DP)] is a lipid emulsion containing dexamethasone, which was developed in Japan (9). This agent provides greater efficacy, and much less risk for systemic adverse effects, than dexamethasone, because the lipid emulsion is easily taken up by phagocytes (10).…”

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confidence: 99%

“…When the same dose of DP or dexamethasone sodium phosphate (DSP) is administrated, the uptake of DP is 8-time higher, it is hydrolyzed slowly, and the anti-inflammatory effect on macrophages is 5-to 6-time higher than DSP (9,10). In addition, DP has fewer side effects, for example, it has little inhibitory effect on the hypothalamus-pituitary-adrenal axis compared with DSP (9).…”

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confidence: 99%

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Liposteroid therapy for juvenile and adult dermatomyositis: efficacy and side effects

Wakiguchi

2017

Ann. Transl. Med.

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confidence: 99%

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confidence: 99%

Liposteroid therapy for juvenile and adult dermatomyositis: efficacy and side effects

Wakiguchi

2017

Ann. Transl. Med.

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“…In rapidly progressive ILD, a combination therapy of methylprednisolone pulse therapy, CsA, and CPA can be administered. Liposteroid, a lipid emulsion containing dexamethasone, provides greater efficacy, and much less risk for systemic adverse effects than dexamethasone sodium phosphate 57. Liposteroid has been effectively used for the treatment of macrophage activation syndrome in Japan, because lipid emulsions are easily taken up by phagocytosis and are retained in macrophages.…”

Section: Introductionmentioning

confidence: 99%

<p>Multispecialty approach for improving outcomes in juvenile dermatomyositis</p>

Wakiguchi¹

2019

JMDH

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Juvenile dermatomyositis (JDM) is a pediatric rheumatic disease characterized by inflammation of the muscle and skin. Prognosis of JDM in children has improved in general owing to medical progress; however, pathogenesis and management of JDM in children and prognosis in refractory JDM remain challenging. For elucidation of JDM pathophysiology and establishment of appropriate treatment for JDM, pediatric rheumatologists need to adopt a multispecialty approach that involves experts in genetics, immunology, pathology, musculoskeletal medicine, dermatology, pulmonology, cardiology, hematology, gastroenterology, endocrinology, ophthalmology, psychology, radiology, pharmacology, physiotherapy, surgery, preventive medicine, and adult rheumatology. Such collaborations will potentially lead to improved outcomes in children with JDM.

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“…Liposteroid dexamethasone palmitate is known for the treatment of rheumatoid arthritis. This drug, which was developed in Japan, is a lipid emulsion containing dexamethasone [ [3] , [4] , [5] ].…”

Section: Introductionmentioning

confidence: 99%

Liposteroid and methylprednisolone combination therapy for a case of idiopathic lung hemosiderosis

Sakamoto

Matsumoto

Mitsubuchi

et al. 2018

Respiratory Medicine Case Reports

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Idiopathic pulmonary hemosiderosis (IPH) is a rare disease in children, with unknown etiology. The classical clinical triad is hemoptysis, hypochromic anemia and diffuse parenchymal infiltrations on chest X-ray. Liposteroid dexamethasone palmitate, which was developed in Japan, has shown good efficacy for IPH. We present the case of a patient with IPH, who suffered from a life-threatening respiratory dysfunction, and was rescued by a trial administration of liposteroid with methylprednisolone (mPSL).A 6-year-old girl was admitted to our hospital for repeated dyspnea and blood-stained sputum. She was diagnosed with IPH at the age of three-months by iron staining of gastric fluid and sputum studies. Her cumulative dose of steroids (equivalent to prednisolone (PSL)) was 1062 mg/kg. However, she could not achieve remission. We decided to initiate liposteroid therapy. We administered an infusion of liposteroid 0.8 mg/kg intravenously, for three consecutive days as a therapy for acute bleeding. After administration of liposteroid, she developed high fever with CRP elevation. We suspected that the inflammation was caused by palmitate, which is present as a lipo base in liposteroid. Hence, we added 2 mg/kg mPSL per day for 1 week. As a maintenance treatment, a single infusion of liposteroid was administered followed by mPSL administration for 6 days in every week. Her respiratory condition slowly improved. Tracheostomy was performed for airway management. She was shifted out of the ICU on the 34th day.Steroid is a key therapy for hemosiderosis. When IPH is diagnosed, oral prednisone therapy is initiated. Although this is effective, there are limitations due to significant adverse effects. Maintaining drug therapy is very important for IPH patients to keep the disease under control. Liposteroid has the same mechanism of action as dexamethasone. It has a Lipo-base, palmitate, which could induce pro-inflammatory cytokine activation. We used mPSL to inhibit the inflammation following liposteroid administration. This was effective. A combination of liposteroid and mPSL administration was useful method of treatment for the patient.

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Clinical utility of the liposteroid therapy: Potential effects on the macrophage activation

Cited by 11 publications

References 40 publications

Liposteroid therapy for juvenile and adult dermatomyositis: efficacy and side effects

Liposteroid therapy for juvenile and adult dermatomyositis: efficacy and side effects

<p>Multispecialty approach for improving outcomes in juvenile dermatomyositis</p>

Liposteroid and methylprednisolone combination therapy for a case of idiopathic lung hemosiderosis

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