Farmacoriflessioni
Infezioni respiratorie ricorrenti
e immunostimolanti
RECURRENT RESPIRATORY INFECTIONS AND IMMUNOSTIMULANTS
L. Lepore1, F. Longo1, F. Panizon2
1Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
2Professore Emerito, Dipartimento di Scienze della Riproduzione e dello Sviluppo, Università di Trieste
Settembre 2008 - pagg. 451 -456
Abstract
As for pharmacological prevention of recurrent respiratory infections Cochrane Library has
examined 579 controlled clinical trials against placebo. The substances tested are very different,
ranging from thymus extracts and synthetic molecules acting on thymus functions,
to non-specific immunomodulants, whose effectiveness is recognised, such as levamisole,
to herbal substances and to homeopathy. The effect of all the substances (except for homeopathy)
has been positive. The results show, in most of the cases, a yearly, bimestrial,
biannual reduction ranging from 30% to 50% in the number of infections. The effect is
usually limited to the period of treatment. The concordance of the results, the high number
of patients studied and most of the multi-centric trials support the natural conclusions that
these substances are effective. Therefore, considering the present knowledge, it seems legitimate
to affirm that different immunostimulants have a positive effect on recurrent infections
that are usually due to an early socialisation in an age in which the immune system
is largely immature. The substantially similar effect of different substances can be acceptably
explained saying that they alarm the toll-like receptors, which are sensitive and nonspecific
stimulators of the primary immune system that recognize short molecular sequences
such as fragments of bacterial, or viral, or vegetal or tissue DNA. The work reports a
series of trials carried out in the ‘80s in the Paediatric Clinic in Trieste (Italy) and by family
paediatricians, who are ACP (Associazione Culturale Pediatri) members. It also reports a
series of reviews or meta-analyses, ending with that by Cochrane.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Chemical Actions and Uses
Pharmacologic Actions
Physiological Effects of Drugs
Immunologic Factors
Adjuvants, Immunologic (5)
Health Care Quality, Access, and Evaluation
Quality of Health Care
Health Care Evaluation Mechanisms
Epidemiologic Research Design
Meta-Analysis as Topic (26)
Health Care Quality, Access, and Evaluation
Quality of Health Care
Health Care Evaluation Mechanisms
Epidemiologic Study Characteristics
Clinical Studies as Topic
Clinical Trials as Topic
Infections
Respiratory Tract Infections (77)
Amino Acids, Peptides, and Proteins
Proteins
Membrane Proteins
Receptors, Cell Surface
Receptors, Immunologic
Receptors, Pattern Recognition
Bibliografia
1. Fior R, Panizon F. Il bambino catarrale. Prospettive
in Pediatria 1975;49:253-62.
2. Longo F, Lepore L, Agosti E, Panizon F. Valutazione dell’efficacia della timomodulina in bambini con infezioni respiratorie ricorrenti. Ped Med Chir 1985;10:603-7.
3. Tamburlini G, Candusso M, Tozzi AE, Greco L. Studio Italiano Infezioni Respiratorie Ricorrenti in Pediatria (SIRP). Medico e Bambino 1988;7:625-41.
4. Lepore L, Longo F, Presani G, Panizon F. Il profilo immunologico del bambino con infezioni respiratorie ricorrenti. Riv Ital Pediatria 1984;10:38-40.
5. Lepore L, Longo F, Presani G, Perticacari S. Difetto dell’immunità ritardata nelle infezioni respiratorie ricorrenti. Immunologia Pediatrica 1982;2:181-3.
6. Lepore L, Longo F, Panizon F. Il bambino con infezioni respiratorie ricorrenti. Medico e Bambino 1986;5:626-9.
7. Lepore L, Longo F, Pennesi M, Barbi E. La funzione immunologica nei bambini con infezioni respiratorie ricorrenti valutata in benessere. Ped Med Chir (Med Sur Ped) 1987;9: 695-8.
8. Ronfani L, Buzzetti R. Efficacia dei farmaci immunostimolanti nella prevenzione delle infezioni respiratorie ricorrenti in età pediatrica. Da: Ugazio AG, Cavagli G. Il bambino con infezioni ricorrenti. Milano: Masson, 2003.
9. Notarangelo LD, Doresina A, Schumacher RF. Infezioni ricorrenti: tra evidenze cliniche e incertezze. Congresso Italiano di Pediatria
2004. Quaderni di Pediatria 2004;3:11-5.
10. Cohen HA, Varsoudi, Kahen E, et al. Effectiveness of an herbal preparation containing echinacea, propolis and vitamin C reduce respiratory tract infections in children: a randomized double-blind placebo-controlled multicentric study. Arch Pediatr Adolesc Med 2004;158:222-6.
11. Hattaka K, Korpela R, Meurman L. Lactobacillus GG reduces infections in children attending day-care centers. Congresso Mondiale di Pediatria e Gastroenterologia, Boston 2000.
12. de Lange de Klerk ES, Blommers J, Kuik DJ, Bezemer PD, Feenstra L. Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent respiratory tract infections. BMJ 1994;309:1329-33.
13. Anonimous. Digest: Immunostimulants for preventing respiratory tract infections in children. Da: The Cochrane Library 2006, issue 4: Medico e Bambino 2007;26:41-4.
2. Longo F, Lepore L, Agosti E, Panizon F. Valutazione dell’efficacia della timomodulina in bambini con infezioni respiratorie ricorrenti. Ped Med Chir 1985;10:603-7.
3. Tamburlini G, Candusso M, Tozzi AE, Greco L. Studio Italiano Infezioni Respiratorie Ricorrenti in Pediatria (SIRP). Medico e Bambino 1988;7:625-41.
4. Lepore L, Longo F, Presani G, Panizon F. Il profilo immunologico del bambino con infezioni respiratorie ricorrenti. Riv Ital Pediatria 1984;10:38-40.
5. Lepore L, Longo F, Presani G, Perticacari S. Difetto dell’immunità ritardata nelle infezioni respiratorie ricorrenti. Immunologia Pediatrica 1982;2:181-3.
6. Lepore L, Longo F, Panizon F. Il bambino con infezioni respiratorie ricorrenti. Medico e Bambino 1986;5:626-9.
7. Lepore L, Longo F, Pennesi M, Barbi E. La funzione immunologica nei bambini con infezioni respiratorie ricorrenti valutata in benessere. Ped Med Chir (Med Sur Ped) 1987;9: 695-8.
8. Ronfani L, Buzzetti R. Efficacia dei farmaci immunostimolanti nella prevenzione delle infezioni respiratorie ricorrenti in età pediatrica. Da: Ugazio AG, Cavagli G. Il bambino con infezioni ricorrenti. Milano: Masson, 2003.
9. Notarangelo LD, Doresina A, Schumacher RF. Infezioni ricorrenti: tra evidenze cliniche e incertezze. Congresso Italiano di Pediatria
2004. Quaderni di Pediatria 2004;3:11-5.
10. Cohen HA, Varsoudi, Kahen E, et al. Effectiveness of an herbal preparation containing echinacea, propolis and vitamin C reduce respiratory tract infections in children: a randomized double-blind placebo-controlled multicentric study. Arch Pediatr Adolesc Med 2004;158:222-6.
11. Hattaka K, Korpela R, Meurman L. Lactobacillus GG reduces infections in children attending day-care centers. Congresso Mondiale di Pediatria e Gastroenterologia, Boston 2000.
12. de Lange de Klerk ES, Blommers J, Kuik DJ, Bezemer PD, Feenstra L. Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent respiratory tract infections. BMJ 1994;309:1329-33.
13. Anonimous. Digest: Immunostimulants for preventing respiratory tract infections in children. Da: The Cochrane Library 2006, issue 4: Medico e Bambino 2007;26:41-4.
Corrispondenza: leporel@burlo.trieste.it