Levamisole-induced immunostimulation in spondylarthropathies

Area of Science:

• Immunology
• Rheumatology
• Pharmacology

Background:

• Seronegative spondylarthritis (S.S.A.) is characterized by specific clinical features, seronegativity, and HLA-B27 phenotype.
• Pathogenesis may involve a genetically controlled immune response defect.

Purpose of the Study:

• To investigate the efficacy of levamisole, an immunostimulant, in treating seronegative spondylarthritis.
• To assess levamisole's impact on immune parameters and clinical outcomes in S.S.A. patients.

Main Methods:

• A randomized controlled crossover study involving 37 men with S.S.A. treated with levamisole or placebo for 12 weeks each.
• Clinical response measured by joint index, spondylometry, morning stiffness, and pain scale. Immunological markers including IgM levels, cytotoxic antibodies, and leucocyte migration inhibition (L.M.I.) were assessed.

Main Results:

• Levamisole significantly improved clinical parameters: joint index, spondylometry, morning stiffness, and pain.
• No radiological progression of sacroiliitis or joint inflammation was observed. Significant reduction in IgM levels and antibodies with weak cytotoxic activity was noted.
• Increased leucocyte migration inhibition (L.M.I.) indicated enhanced immune response.

Conclusions:

• Levamisole demonstrates immunostimulating properties that may positively interfere with defective immunoregulation in S.S.A.
• Treatment with levamisole led to significant clinical improvement and potentially altered the disease course in S.S.A. patients.