CIDPUSA.org Autoimmune diseases

Tetracycline and its derivatives, such as, oxytetracycline, minocycline, doxycycline,  are naturally occurring  compounds that exhibit a well known broad-spectrum antibacterial activity that interferes with protein synthesis at the ribosome level. In addition to this well known antibacterial activity these compounds also exhibit a distinct anti-inflammatory properties. Tetracycline and related compounds have been shown to be effective chemotherapeutic agents in a wide variety of chronic inflammatory diseases and conditions. These include periodontitis, rosacea, acne, auto-immune diseases such as rheumatoid arthritis and protection of the central nervous system against trauma and neurodegenerative diseases such as stroke, multiple sclerosis and Parkinson disease. Tetracycline and related compounds appear to be beneficial for treatment of several chronic inflammatory airway diseases. Among them are asthma, bronchiectasis, acute respiratory distress syndrome, chemical induced lung damage and cystic fibrosis. The clinical use of tetracycline-type drugs in treatment of chronic airway inflammation is becoming a topic ofintense interest.

Tetracyclines: nonantibiotic properties and their clinical implications.

Tetracyclines are broad-spectrum antibiotics that act as such at the ribosomal level where they interfere with protein synthesis. They were first widely prescribed by dermatologists in the early 1950s when it was discovered that they were effective as a treatment for acne. More recently, biologic actions affecting inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism have been researched. The therapeutic effects of tetracycline and its analogues in various diseases have also been investigated. These include rosacea, bullous dermatoses, neutrophilic diseases, pyoderma gangrenosum, sarcoidsis, aortic aneurysms, cancer metastasis, periodontitis, and autoimmune disorders such as rheumatoid arthritis and scleroderma.

Anti-inflammatory activity of tetracyclines

Tetracyclines are known to exhibit multiple significant anti-inflammatory actions. This article describes the mechanisms of this anti-inflammatory activity, such as inhibition of chemotaxis, granuloma formation, and protease. The article also discusses the effectiveness of tetracyclines in treating such diseases as acne vulgaris, rosacea, bullous dermatoses, granulomatous disease, and livedo vasculitis.

Positive side-effects of antibiotic and antimicrobial drugs in therapy

Since about 1950 especially, dermatologists world-wide have been utilizing the positive side-effects, discovered by chance, of all groups of antibiotic and antimicrobial drugs. These drugs are used to treat certain non-microbially induced dermatoses, without any knowledge of the mechanisms involved. A short history is given and the most important drugs and the indications for their use are described. The following drugs are undoubtedly effective and sometimes even the therapy of choice:

 tetracyclines in acne vulgaris and rosacea (including rosacea keratitis);

penicillin G in acrodermatitis atrophicans and cold urticaria; dapsone in dermatitis herpetiformis and - as a powerful adjuvant - in acne vulgaris and rosacea. Before the discovery of the socalled immunodepressive drugs, tetracycline was the only alternative to - or at least a highly effective adjuvant of - cortisone in dermatomyositis and chloroquine in localised and systemic lupus erythematosus.

 Finally, clioquinole was life-saving in acrodermatitis continua in children until this condition was recently identified as a zinc-deficiency syndrome. Therapeutical mechanisms have been found only in the case of acne, rosacea and dermatitis herpetiformis. In most other diseases the nature of the therapeutical effectiveness of antibiotic and antimicrobial drugs still remains a mystery.