Covelli V, Maffione A B, Greco B, Cannuscio B, Calvello R, Jirillo E
Clinica Neurologica, II Faculty of Medicine, University of Naples, Italy.
Immunopharmacol Immunotoxicol. 1993 Aug;15(4):415-28. doi: 10.3109/08923979309035237.
Over the past few years, the immunomodulating role of benzodiazepines (BDZ) has been reported in literature. In particular, diazepam is an inhibitory BDZ with regard to its effects on the phagocytic and metabolic activities of polymorphonuclear cells (PMN) and monocytes, while triazolobenzodiazepines (alprazolam and triazolam) upregulate normal human peripheral blood T lymphocyte function. On these grounds, the administration of alprazolam (1 mg/per day for 1 month) in 13 patients with migraine without aura (MWA) and of lorazepam (2 mg/per day for 1 month) in 10 matched MWA subjects has been evaluated in terms of immune response. Results show that before administration of BDZ in both groups of patients phagocytosis and killing of PMN and monocytes were profoundly depressed and the same was true for the lymphocyte-dependent antibacterial activity. After one month treatment lorazepam further decreased lymphocyte function without modifying phagocytic capabilities. On the contrary, alprazolam increased PMN phagocytosis and killing and monocyte phagocytosis without modifying antibacterial activity values. Taken together, these results further support the existence of different classes of BDZ in terms of their immunomodulating capacities. Moreover, alprazolam seems to be a more appropriate BDZ for treating immunocompromised patients, even including MWA patients.
在过去几年中，文献报道了苯二氮䓬类药物（BDZ）的免疫调节作用。特别是，地西泮是一种抑制性苯二氮䓬类药物，对多形核细胞（PMN）和单核细胞的吞噬及代谢活性有影响，而三唑苯二氮䓬类药物（阿普唑仑和三唑仑）可上调正常人外周血T淋巴细胞功能。基于这些原因，对13例无先兆偏头痛（MWA）患者给予阿普唑仑（每天1毫克，持续1个月），并对10例匹配的MWA受试者给予劳拉西泮（每天2毫克，持续1个月），评估其免疫反应。结果显示，在两组患者服用苯二氮䓬类药物之前，PMN和单核细胞的吞噬及杀伤能力均显著降低，淋巴细胞依赖性抗菌活性也是如此。经过1个月的治疗，劳拉西泮进一步降低了淋巴细胞功能，但未改变吞噬能力。相反，阿普唑仑增加了PMN的吞噬及杀伤能力和单核细胞的吞噬能力，而未改变抗菌活性值。综上所述，这些结果进一步支持了不同类别的苯二氮䓬类药物在免疫调节能力方面的存在差异。此外，阿普唑仑似乎是治疗免疫功能低下患者（甚至包括MWA患者）更合适的苯二氮䓬类药物。
