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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

1999, Número 2

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Alerg Asma Inmunol Pediatr 1999; 8 (2)


Desórdenes inmunológicos y el resurgimiento de la talidomida. Nuevas aplicaciones clínicas

Cejudo RC

Idioma: Español
Referencias bibliográficas: 57
Paginas: 49-56
Archivo PDF: 389.55 Kb.


RESUMEN

La talidomida fue sintetizada en 1954 en Alemania Oriental. Los estudios preliminares de esta droga la mostraron segura y sin efectos teratogénicos. Su prescripción inicial fue en el primer trimestre del embarazo como antiemético, sedante e hipnótico. Cuando su uso se correlacionó con severos defectos en extremidades, ocasionando efectos teratogénicos devastadores en miles de recién nacidos, el impacto en el mundo y la medicina fue tal, que el repudio y el no contar con otras aplicaciones médicas hicieron que esta droga permaneciera en el olvido y estuviera a punto de desaparecer. No fue hasta que Sheskin en 1965, al utilizar talidomida como efecto sedante en pacientes con eritema nodoso lepromatoso, observó que las lesiones mejoraban en forma sorprendente. La sobrevivencia de la talidomida se debe a este gran descubrimiento. La talidomida se utiliza actualmente, en diversos desórdenes dermatológicos e inmunológicos. Es una droga antiinflamatoria e inmunomoduladora, y no inmunosupresora, que actúa sobre células fagocíticas y células endoteliales, pero no tiene efecto directo sobre los linfocitos T. El uso de talidomida implica dos riesgos: El primero, su conocido efecto teratogénico, lo que condiciona un adecuado control de natalidad en mujeres en edad fértil. El segundo, su potencial en la inducción de polineuropatía periférica. La talidomida tiene un potencial claro como inmunomodulador; sin embargo, se deberá tener conocimiento en su mecanismo de acción, teratogenicidad y neurotoxicidad, lo que nos permitirá su uso, en una forma segura.


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