Nicotine May Help Treat Sepsis

Tobacco Ingredient May Fight Common Infection

From the WebMD Archives

Oct. 25, 2004 -- The active ingredient in tobacco may actually have a beneficial effect on the body in treating a common and potentially deadly type of infection process known as sepsis, new research shows.

Sepsis is the third leading cause of death in developed countries and accounts for nearly 9% of deaths in the U.S. each year. The condition begins as an infection that activates the entire immune system to an exaggerated degree. The immune system then sets off a chain of events that can lead to uncontrolled inflammation in the body, shock, and eventually death.

Until recently, the only way doctors could treat sepsis was with powerful antibiotics and other supportive care. In 2001, the drug Xigris became the first available therapy for sepsis and has been shown to reduce the risk of death due to the condition. But treatment options for sepsis remain limited.

In the study, researchers found a dose of nicotine helped block the dangerous inflammatory reaction in laboratory rats with sepsis. Researchers say the results indicate that nicotine and other molecules that resemble it may prove useful in the treatment of sepsis in humans.

Nicotine May Be New Sepsis Treatment

During an infection, cells from the immune system, called macrophages, release various chemicals which act as alarms. Too many of these compounds in the blood are harmful and can cause excess inflammation and septic shock. The body can sense these chemicals during an infection and can release acetycholine to help stop the production of these inflammatory compounds.

In the study, researchers looked at the effects of nicotine on the inflammatory response. Nicotine mimics acetycholine and can act like a brake to stop the chain of inflammation.

Acetycholine has many functions but its anti-inflammatory action depends on where it binds. Cells from the immune system that help fight infection -- and release inflammatory compounds -- have receptors that bind to acetycholine but can also bind to nicotine.

Their study showed that nicotine was actually more effective than acetylcholine in stopping the inflammatory process in rats with sepsis. Treatment with nicotine reduced the rats' risk of death, even when the nicotine treatment was started after the disease process had begun.

Of course further studies will be needed to see if nicotine would have the same anti-inflammatory effects in humans with sepsis. But researchers say the findings show new avenues for sepsis treatment.

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SOURCES: Wang, H. Nature Medicine, Oct. 24, 2004 online edition. WebMD Medical News: "Sepsis Cases on the Rise in the U.S."
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