Kodama Mitsuo, Kodama Toshiko
Kodama Research Institute of Preventive Medicine, 50-5 Chiyogaoka, Chikusaku, Nagoya 464-0005, Japan.
In Vivo. 2006 Mar-Apr;20(2):285-91.
Since 1996 in our clinic, the regular practice of megadose vitamin C infusion with dehydroepiandrosterone-cortisol annex and the continuous intake of erythromycin and chloramphenicol have been found useful for the clinical control of the autoimmune disease interstitial pneumonia, also known as chronic fatigue syndrome. The long-term use of these two systems for the treatment of the autoimmune disease has led to the emergence of four problems of theoretical or practical importance, as described below: i) Should maintenance of the above core treatments be continued for prophylactic purposes in the absence of acute signs of pneumonia? Evidence indicated that their use was essential to arrest the dynamic activity of an intrapulmonary bacterial colony in the immunodeficient host, and that the 5-year survival rate of interstitial pneumonia patients would have been worse without the prophylactic practice of the 2 treatments. ii) Evidence was presented to suggest that the activity of the intrapulmonary bacterial colony was becoming less responsive because of the emergence of a drug-resistent mutant bacterium. The introduction of new antibiotics (kanamycin) was found to improve the acute signs of pneumonia. iii) The bone marrow function of one male patient with interstitial pneumonia was found to decline during the observation period of 9 years. It was speculated that his bone marrow, like his lungs, was in the course of fibrosis. iv) One female patient was diagnosed with breast cancer in the course of interstitial pneumonia treatment--an example indicating that the persistence of an autoimmune disease in an elderly subject might be associated with the emergence of malignancy. Dehydroepiandrosterone was shown to promote the recovery of hepatic function in the course of cancer chemotherapy with cyclophosphamide. The beneficial effect of the adrenal androgen was dose-dependent. The significance of this finding is discussed in the light of the steroid carcinogenesis concept. The reasoning behind the view that interstitial pneumonia and chronic fatigue syndrome are one disease is also discussed.
自1996年起，在我们的诊所中，发现大剂量输注维生素C并辅以脱氢表雄酮 - 皮质醇以及持续服用红霉素和氯霉素，对于自身免疫性疾病间质性肺炎（也称为慢性疲劳综合征）的临床控制很有用。长期使用这两种方法治疗自身免疫性疾病引发了四个具有理论或实际重要性的问题，如下所述：i）在没有肺炎急性症状的情况下，是否应继续维持上述核心治疗以作预防？有证据表明，它们的使用对于阻止免疫缺陷宿主肺内细菌菌落的动态活动至关重要，而且如果没有这两种治疗的预防性应用，间质性肺炎患者的5年生存率会更差。ii）有证据表明，由于耐药突变细菌的出现，肺内细菌菌落的活性变得反应性降低。发现引入新抗生素（卡那霉素）可改善肺炎的急性症状。iii）在9年的观察期内，发现一名间质性肺炎男性患者的骨髓功能下降。据推测，他的骨髓和肺部一样，正处于纤维化过程中。iv）一名女性患者在间质性肺炎治疗过程中被诊断出患有乳腺癌——这一例子表明，老年患者自身免疫性疾病的持续存在可能与恶性肿瘤的出现有关。脱氢表雄酮在环磷酰胺癌症化疗过程中显示可促进肝功能恢复。肾上腺雄激素的有益作用是剂量依赖性的。根据类固醇致癌概念对这一发现的意义进行了讨论。还讨论了认为间质性肺炎和慢性疲劳综合征是同一种疾病的观点背后的推理。
