Fisiopatología de los eventos psiquiátricos asociados al uso de interferón alfa.
O Bondolfi, A Cipolla
Dra. Olga
Dra. Olga Bondolfi, Dra. Andrea Cipolla del triptófano, la neurotransmisión serotonérgica, glutamatérgica y dopaminérgica, así como con la activación del eje HPA. Estos eventos adversos usualmente se resuelven luego de finalizado o interrumpido el tratamiento con IFN, pero pueden persistir o aún agravarse luego de su discontinuación. Por lo tanto, queremos destacar la importancia de la prevención, con la información al paciente y sus familiares, el monitoreo permanente y eventualmente la utilización precoz de la medicación. El segundo tema de relevancia es el estudio del catabolismo del triptófano en el sistema inmune y su relación con las reacciones inflamatorias en una amplia serie de enfermedades de autoinmunidad y neurodegenerativas. Incluimos en nuestra revisión investigaciones realizadas, especialmente en los últimos años, sobre las propiedades inmunomodulatorias de la IDO y los metabolitos de la vía de las kynureninas, con la posibilidad de desarrollo de nuevos blancos terapéuticos, siendo de nuestro especial interés lo vinculado a las posibilidades de alivio de la neurotoxicidad y posibilidades de neuroprotección. Referencias bibliográficas 1. Ceballos A y Sabatté J. Inmunidad antiviral. Leonardo Fainmboim y Jorge Geffner. Introducción a la Inmunología Humana. 5ª ed. Buenos Aires: Médica Panamericana, 2005- p. 262-63. 2. Onyke CU, Bonner JO, Lyketsos CG, et al. Mania during treatment of chronic hepatitis C with pegylated interferon and ribavirin. Am J Psychiatry 2004; 161:429-35. 3. Fattovich G, Giustina G, Favarato S, et al. A survey of adverse events in 11.241 patients with chronic viral hepatitis treated with alpha interferon. J. Hepatol 1996; 24:38-47. 4. Musselman DL, Lawson DH, Gumnik JF, et al. 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