Immune system & NSAID's...

[Chels]

This is quite random, anyway there is something being bugging me.

The whole point in the inflammatory response is to result in the healling of the site of injury right? And all the processes involved initiate a load of other processes too, which in turn activate more processes and cascades and well and...well, the whole matrix of "the inflammatory response"

What gets to me is - WHY do medical practitioners like to prescribe people high doses of anti-inflammatories, when they have other injuries? For example, my grandmothers friend suffers from leg ulcers and arthritis. Her doctor treats her arthritis with co-dydramol and Diclofenac.

Diclofenac interferes with pathways that lead to the availability of leukotrienes and prostaglandins.

This is pretty scary, especially when you think about all the pro-inflammatory response things that prostaglandins do......

This particular old biddie also has this topical ointment that she seems to be addicted to - voltarol gel. Now, that contains Diclofenac also. So she is getting the maximum oral dose, along with half the tube of diclofenac absorbed into her skin every day, its no wonder her leg ulcers won't heal, at least thats what i'm thinking. Obviously she needs a painkiller for her arthritis, but why not prescribe co-codamol and eliminate the diclofenac? maybe adding (temporarily) codeine phosphate, she will be stoned out her box for a while as her legs heal, possibly, but as a short term measure??

i also read a few times about the reduction in formation of leukotrienes - now aren't these important chemotactins for neutrophils?

lower level of these, lower number of attracted neutrophils, lower healing time.

i just can't seem to find any articles or proper solid information on this apart from the usual "stomach ulcers prostaglandins NSAIDS link", i find it pretty scary that these NSAID's are so readily available to people who could be taking them for a number of reasons not expecting, e.g, the pills that keep the pain from the abcess away are also interfering with its healing process!

Shouldn't these things come with some kind of warning on them!? Maybe i'm just reading waay too much into this.

thing is - i know inflammation is not "the healing process" in itself but it does work with other methods to promote healing, if you look at the very end process it involves removal of the pathogen and restoration of the damaged tissue to its normal homeostasis, they are not two completely separate processes, all the involved steps interlink.

What i am basically saying is yes, the NSAID's reduce inflammation because of their inhibition of prostaglandins, (which makes me wonder what happens to the NON-cleaved arachidonic acid? Hmm, more leukotrienes possibly?? i'll leave that for another day)

but remembering that prostaglandins have effects on almost every step in the inflammatory response, i mean they are involved with vasodilation, platelet aggregation, cell growth (repairing mechanism, no?), smooth muscle cell constriction and/or dilation depending on type i think.... they reduce the concentrations of the chemicals involved therefore consequently defeat the entire purpose and effect of the inflammatory response - which would (possibly, maybe) result in a reduced ability to fight infectious agents and remove pathogens.

 

i could be talking utter garbage here, it was just a random thought.