Treatment of Lupus Erythematosus With Mepacrine

Page, Francis

doi:10.1016/s0140-6736(51)91643-1

Cited by 293 publications

(71 citation statements)

References 1 publication

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“…Within the middle of 20th century, systematic studies on AMs in rheumatic diseases have been performed and scientific evidences were published [11][12][13]. Since then, AMs have been used to treat with success rheumatic disorders, even if, at today, the mechanisms of action of AM drugs as antinflammatories and immunomodulators is not completely unravelled.…”

Section: Story Of Antimalarials: From Cinchona Bark To Atabrinementioning

confidence: 99%

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

Piscianz

Cuzzoni

Sharma

et al. 2018

CMC

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The story of antimalarials as antinflammatory drugs dates back few centuries. Chinin, the extract of the Cinchona bark, has been exploited since the 18th century for its antimalarial and antifebrile properties. Later, during the Second World War, the broad use of antimalarials allowed arguing their antirheumatic effect on soldiers. Since then, these drugs have been broadly used to treat Systemic Lupus Erythematosus, but, only recently, the molecular mechanisms of action have been partly clarified.The inhibitory action on vacuole function and trafficking has been considered for decades the main mechanism of the action of antimalarials, affecting the activation of phagocytes and dendritic cells. In addition, chloroquine is also as a potent inhibitor of autophagy, providing another possible explanation of its antinflammatory action. However, much attention has been recently devoted to the action of antimalarials on the so-called cGAS-STING pathway deputed to the sensing of nucleic acid and to the production of type 1 interferons. This pathway is a fundamental mechanism for host defence, since it is able to detect microbial DNA and RNA and induce the immune response that will lead to the production of interferons. Of note, genetic defects in disposal of nucleic acids lead to inappropriate activation of the cGAS-STING pathway and inflammation. These disorders, named type I interferonopathies, represent a valuable model to study the antinflammatory potential of antimalarials.We will discuss possible development of antimalarials to improve the treatment of type I interferonopathies and, likely multifactorial disorders characterised by interferon inflammation, such as systemic lupus erythematosus.

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Section: Story Of Antimalarials: From Cinchona Bark To Atabrinementioning

confidence: 99%

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

Piscianz

Cuzzoni

Sharma

et al. 2018

CMC

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“…In 1951, Page [2] described a series of 18 patients with LE successfully treated with quinacrine. Quinacrine in duces a jaundice-like discoloration of the skin.…”

Section: Introductionmentioning

confidence: 99%

The Association of the Two Antimalarials Chloroquine and Quinacrine for Treatment-Resistant Chronic and Subacute Cutaneous Lupus erythematosus

1994

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Antimalarials are the first line in the treatment of chronic and subacute cutaneous lupus erythematosus (LE). However, some patients show either no or only minor improvement on antimalarial monotherapy. We treated 14 patients (9 with chronic LE and 5 with subacute cutaneous LE) who had poorly responded to chloroquine or hydroxychloroquine with an association of chloroquine and quinacrine. The initial dose was: chloroquine 100 mg 3 × /day and quinacrine 65 mg 3 × /day. The skin lesions improved significantly or cleared totally in 5 of the 9 patients with chronic LE and in all the 5 patients with subacute cutaneous LE. These findings suggest that a chloroquine-quinacrine combination may sometimes be superior to the usual antimalarial monotherapy, especially for subacute LE. If chloroquine or hydroxychloroquine fails to control chronic or subacute cutaneous LE, chloroquine-quinacrine is worthy to be tried.

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“…4-Aminoquinoline derivatives have been used since 1951 in the treatment of LE [3]. HChas been preferred to chloroquine mainly due to its lesser ocular toxicity [4].…”

Section: Discussionmentioning

confidence: 99%

Effects of Hydroxychloroquine on ‘Band Test’ in Discoid Lupus erythematosus

Chieregato

Peroni²,

Castellani³

et al. 1990

Dermatology

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Ten cases of localized and generalized discoid lupus erythematosus are reported in which previously untreated patients were given hydroxychloroquine sulphate 600 mg daily for 10 days followed by 400 mg for 20 days. The purpose of the study was to evaluate the effect of this drug on the ‘lupus band’ before and after treatment, in diseased, unaffected sun-exposed, and unaffected non sun-exposed skin. A good response from both the clinical and immunopathologic (i.e. reduction or disappearance of the immune reactants) standpoint was evident in 6/10 patients; in another 3 patients a good clinical but not immunopathologic response was recorded, while in 1 case a clinical worsening corresponded to an immunofluorescence improvement. In 5/10 cases (4 females 1 male) one or more immunoglobulin classes which were present in the ‘lupus band’ before therapy remained at the dermoepidermal junction after treatment.

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Treatment of Lupus Erythematosus With Mepacrine

Cited by 293 publications

References 1 publication

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

The Association of the Two Antimalarials Chloroquine and Quinacrine for Treatment-Resistant Chronic and Subacute Cutaneous Lupus erythematosus

Effects of Hydroxychloroquine on ‘Band Test’ in Discoid Lupus erythematosus

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