Biography:

One of their most recent publications is Effect of chlorpromazine on hypersensitivity to DNCB in the Guinea-pig. Which was published in journal Journal of Neuroimmunology.

More information about J. Descotes research including statistics on their citations can be found on their Copernicus Academic profile page.

J. Descotes's Articles: (13)

Effect of chlorpromazine on hypersensitivity to DNCB in the Guinea-pig

AbstractChlorpromazine, a phenothiazine derivative useful in the treatment of various mental disorders, was found to depress contact hypersensitivity to dinitrochlorobenzene in guinea-pigs. This drug proved equipotent on the various phases of this delayed-type immune response. The observed immunodepression is consistent with previously reported untoward reactions to chlorpromazine and might have consequences which deserve further evaluation in the management of psychiatric patients.

Immunotoxic effects of xenobiotics in humans: A review of current evidence

AbstractImmunotoxic effects include immunosuppression and immunostimulation, hypersensitivity and autoimmunity. Infections and lymphoproliferative disorders have been associated with the use of immunosuppressive drugs, whereas infections have seldom been associated with chemical exposure. Fewer drugs and chemicals have been shown to enhance immune parameters. Clinical consequences, (i.e. flu-like syndromes, autoimmune reactions, facilitated allergic reactions to unrelated antigens and impaired hepatic drug metabolism) mostly have been associated with recombinant cytokines. Hypersensitivity reactions have commonly been reported in treated patients as well as in exposed workers. Autoimmune reactions have been associated with only a few drugs. Overall, current evidence suggests that marked immune changes in humans exposed to xenobiotics can result in overt clinical toxicities, but it remains to be established to what extent mild to moderate immune changes described in animals and/or humans can result in immune-mediated diseases. This issue could be investigated by the follow-up of selected cohorts, for example patients from clinical trials, exposed workers, or inhabitants of heavily polluted areas, using standardized and validated immunology assays, together with the identification of sentinel immune diseases.

Immunomodulating agents

Publisher SummaryThis chapter explains immunomodulating agents. It describes individual compounds of natural origin such as interferon-γ, which has numerous immunoregulatory activities, the potential therapeutic benefit of which is under extensive study. Interleukin-2 and its effect which reportedly is shown to induce tumor regression in certain patients with progressive, metastatic cancer has been examined. There is some discussion about monoclonal antibodies and its side effects such as fever, shivering, abdominal pain, diarrhea, and nausea/vomiting have been discussed. OK-432 (picibanil), richin A chain immunotoxin, and tumor necrosis factor.. Individual synthetic compounds such as CL-246738 and LC-9018 have been also been described.

Immunomodulating agents

Publisher SummaryThis chapter discusses several immunomodulating agents and their adverse effects. Bacillus calmette-guerin (BCG) is a useful addition to the treatment of bladder carcinoma in situ. Major hematuria, irritative symptoms, irritable bladder, and miliary BCG infection were only noted in patients receiving intravesical BCG whereas nausea and vomiting were noted in orally treated patients. Even though immunotherapy with monoclonal antibodies (Mab) has been disappointing in many instances, extensive efforts are devoted to identify patients who may benefit from this treatment. The intrapericardial injection of OK-432 in 10 patients with malignant pericardial effusion resulted in fever and chest pain easily controlled with antipyretics in 6 patients and profound hypotension in 2. Sizofiran, an extract from the culture broth of Schizophyllum commune Fries, was administered to 192 Japanese patients with resectable gastric cancer. Only 5 patients developed adverse effects; the effects were mild and temporary redness, swelling, induration and/or rash at the site of injection.

Local anaesthetics

Publisher SummaryThe systemic toxicity of local anaesthetic agents involves both the central nervous system and the cardiovascular system. However, the central nervous system is more often implicated in these toxic reactions; dizziness, tinnitus, muscle twitching, and finally seizures may develop, mainly following the rapid inadvertent intravenous injection of a local anaesthetic agent. A case of cardiac arrest following etidocaine caudal anaesthesia in a 31-year-old man has been observed recently. This accident was due to direct injection of etidocaine into the caudal canal, but the patient recovered uneventfully. However, direct intravascular injections rarely lead to cardiac arrest, convulsions being the commonest side effect. Benzocaine, amethocaine, butacaine, procaine, and other local anaesthetics derived from para-aminobenzoic acid might on theoretical grounds interfere with the antibacterial action of sulphonamides, but it is doubtful whether the quantities present in the system are likely to produce clinically important interaction. Lidocaine used systemically as an anti-arrhythmic agent can induce interactions not seen when it is used as a local anaesthetic agent.

General anesthetics and therapeutic gases

Publisher SummaryThis chapter discusses general anesthetics and therapeutic gases. The chapter emphasizes on the increased anesthesiologic risk in patients premedicated with tricyclic antidepressants: dangerous cardiac arrhythmias can occur, probably due to disturbances of the physiologic effects of catecholamines. Acute intermittent porphyria is another risk factor. Plasma insulin fell from average preanesthesia levels of 16 mU/ml to 8 mU/ml 30 minutes after induction of anesthesia with d-tubocurarine, thiamylal and succinylcholine followed by halothane and nitrous oxide-oxygen. In addition, the acute insulin response to glucose fell by 50%. Malignant hyperthermia is a rare but severe complication of general anesthesia the characteristics of which are currently under extensive investigation. The adverse effect of intravenous administration of anesthetics is also discussed in the chapter. Althesin-induced convulsions showed an exacerbation of the epileptiform electroencephalography discharges following althesin administration in 18 unpremedicated patients with central nervous system diseases.

Local anesthetics

Publisher SummaryThis chapter focuses on the adverse effects of local anesthetics. Systemic toxicity is the leading cause of side effects related to local anesthesia. Such systemic toxic effects develop when the blood concentration of a local anesthetic exceeds a given limit. As blood levels increase, drowsiness, ringing in the ears and double vision occur, culminating in convulsions. Excessive doses, inadvertent intravascular injections and use in certain pathologic conditions which affect either the storage of local anesthetics or their biotransformation should be carefully avoided (IR). The systemic toxic potential of local anesthetics in any case varies: bupivacaine, tetracaine and dibucaine are considered the most toxic derivatives. Several cases of contact sensitivity to lidocaine is reported with cross-reactivity to bupivacaine, mepivacaine, prilocaine and cincaine, but not to tetracaine. The use of ester type local anesthetics is therefore recommended in amide-type sensitive patients.

General anesthetics and therapeutic gases

Publisher SummaryThis chapter discusses the adverse effects related to the use of general anesthetics and therapeutic gases. The chapter focuses on risk factors that include risks associated with interactions, multiple inhalation anesthesia, surgical atmospheric pollution, hemostasis and platelet functions, malignant hyperthermia, and severe hypersensitivity reactions. Failure to detect responsible drugs by adequate investigation and to appreciate the possibility of cross-sensitivity is a pitfall, which is difficult to avoid. The chapter illustrates implications of individual compounds divided into the categories of gases, such ase cyclopropane and enflurane and intravenous agents, such as Althesin and barbiturates.

Local anesthetics

Publisher SummaryThis chapter discusses the local anesthesia that provides a safe and effective method of preventing or relieving pain. However, knowledge of the pharmacological properties of available agents, technical skill and careful evaluation of the patient's clinical status clearly are mandatory prerequisites for the judicious use of local anesthetics; data on the frequency and severity of adverse effects may thus reflect in part upon the user rather than the agent employed. Several recent reports, dealt with in the present chapter, illustrate this fact. Systemic toxicity involving either the cardiovascular system or the central nervous system, or both, is consistently regarded as the primary cause of complications of local anesthesia. More attention is currently being paid to preventive and supportive measures such as close monitoring of patients, administration of intravenous fluids before major regional block, immediate availability of equipment to treat systemic toxicity, preoxygenation, injection of a test dose, and incremental dosing.

Immunomodulating agents

Publisher SummaryImmunotherapeutic approach is increasingly being used in cancer treatment. This chapter discusses some speculations on the immunotherapy of allergic diseases. In spite of the considerable potential, the field of immunomodulating agents is progressing quite slowly. Interleukin-2 is a glycoprotein lymphokine produced by activated T-lymphocytes, which has been shown to play an important role in the immunological response. Administration of interleukin-2 may prove useful in the therapy of severe infectious diseases, particularly those developing in immunocompromised patients. Interleukin-2 has also been proposed as treatment for immunodeficiency. Intravenous administration of Staphylococcus aureus preparations may induce life-threatening cardiovascular and respiratory toxicity. Schizophyllan, a glucan extracted from the culture broth of Schizophyllum commune has been evaluated in association with tegafur for the treatment of resectable gastric cancer. An unexpectedly high rate of adverse reactions was reported among 15 patients with chronic lymphocytic leukemia who received 300 mg oral levamisole per week for four weeks; the most severe hematological complication was thrombopenia. Tiredness, headache, anorexia were noted twice, whereas bitter taste in the mouth, dizziness, arthralgia and a flu-like syndrome developed once.

Local anesthetics

Publisher SummaryThis chapter discusses local anesthetics. Local anesthetics are generally considered safe drugs, although severe accidents are sporadically reported. Most mishaps are due to the failure to take the necessary precautions and to the inability to recognize and promptly treat an adverse reaction. The vasoactivity of a local anesthetic agent is one of the factors determining its duration of action: amide local anesthetics, that is, cinchocaine, lidocaine, mepivacaine and prilocaine proved to produce less vasodilatation than amide agents, which are tetracaine and procaine in healthy human volunteers; it is a finding which is also likely to account for the diminished toxicity of the former agents. Hypersensitivity reactions remain one of the major problems related to local anesthesia. The role of pseudoallergic mechanisms, particularly those involving psychoneurogenic reflexes, has been re-emphasized. The placental transfer and fetal side effects of local anesthetic agents have been extensively reviewed. In pregnancy, the addition of adrenaline, which may decrease uterine blood flow and paracervical blockade and may result in elevated fetal drug blood levels and possibly fetal bradycardia, should be avoided.

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