Pentosan

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Pentosan polysulphate

Initial information

Full information should follow publication in a scientific journal.

Pentosan polysulphate is a sulphated chain of xylose sugars that are

linked together. Because of this it is a huge molecule that

is soluble and has been used as a drug since around 1960. Initially it

was used as an anticoagulant (large doses i.v.) then it was

used as an anti-inflammatory agent (smaller doses by injection) and

then it was used as the major treatment for interstitial

cystitis (oral). The drug is made from beechwood shavings and is

cheap.

It has major properties in preventing the growth of cancers (due to

its stopping of the growth of the blood vessels that are

needed for the cancer growth), AIDS infection (only been shown to work

in test tubes), and in amyloidoses (in test tubes).

Side effects

1. decrease in blood clotting if the level in the blood is high

enough. Not seen when given orally

2. decrease in the number of platelets in the blood if the level

is high enough. Not seen when given orally.

3. allergic responses in the skin (rare). Not currently reported

after oral use of the drug.

4. bleeding from the gut if the drug is given orally for long

periods (over 2 months)

5. rare side effects of decrease in platelets levels to dangerous

levels. This appears in possible 1 in 30,000 people given

the drug i.v. (similarly to heparin) but has not been seen in

patients given the drug orally yet. The level of the drug in the

blood when given orally may preclude this.

In general, as long as the drug is given for relatively short periods

(less than 2 months) orally there should be minimal side

effects.

Problems with side effect testing

1. No adequate data in children

2. No adequate data in haemophiliacs concerning gut bleeding.

3. Gut bleeding must be a direct effect of the drug as it can be

used as a reliable method for producing this in

experimental rats.

Research in the past

Shown to be active in preventing the transmission of scrapie from

hamsters and mice to another of the same species (i.e. the

easiest route). It did not seem to matter whether the drug was given

i.v. or intraperitoneally or whether the disease was

injected i.v. or intraperitoneally. Multiple doses were much greater

than single doses (expt done with dextran sulphate 500).

Low doses of disease could be stopped from transmission altogether and

the animals actually did not have infection in their

body after a single injection of the drug. Work in humans have shown

very low levels of toxicity when given orally and why

this is so. Pharmacokinetic studies have indicated exactly where the

drug goes inside the body and how it gets there. This

indicated that the studies in mice and hamsters used doses of the drug

that were dramatically too high and that many small

doses would be expected to be more effective.

Considered potential use in humans

Blood transfusions, and other conditions by which people may be

exposed to inoculations of UK body fluids or tissues.

People that carry familial genes associated with CJD, GSS, FFI etc.

The possibility of giving the drug to people that might be

infected with BSE is still being considered.

Dose

Currently it is expected that it would be given for 2 months to adults

at 100mg tds. All on going treatments should be part of a

clinical trial. The drug is not currently available in the UK except

by named patient prescription from an individual doctor. It is

produced by Norton Health Care, Harlow, Essex.

Full information will follow

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e-mail to

Steve Dealler at deal@...

Articles for publication should be sent to me at: The Pathology

Laboratory, Burnley General Hospital, Burnley, UK BB10

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