Polyinosinic-Polycytidylic Acid Poly-L-lysine (PolylCLC)
W. KING ENGEL, PETER G. BERNAD, and HILTON B. LEVY, Bethesda, MD
We introduced PolylCLC (stablized with carboxymethyl cellulose) as a new treatment for dysimmune dysschwannian neuropathy (DSN) in one patient (Lancet 1:503, 1978). Off all other drugs for more than 1.5 years, he continues after 3 years to benefit and be dependent upon PolylCLC. Now age 31, he has had motor DSN from age 15, and eventually was refractory to prednisone, azathioprine, and plasmapheresis. Confined to an electric wheelchair and hardly able to use his limbs before PolylCLC, now, at the peaks of PolylCLC action, he is normal proximally and much improved distally, and can walk 8 miles a day. Four of seven other motor-sensory DSN and two of two dysimmune dysneuronal motor-sensory neuropathy patients refractory to other drugs now have beneficial responses extending over 1-2 years, allowing elimination or major reduction of any other medications. Each IV dose (20-100 ng/kg) of PolylCLC causes benefit lasting 2-6 weeks. Acutely, there is 4-18 hours flu-like syndrome, 4-5 days selective lymphocyto-penia to 1-20 percent of baseline, 24-48 hours granulocytosis 2-3 x baseline, 48 hours hypercorticoidemia, and minimal < 24 hours hyperinterferonemia. The beneficial effect of Poly-IULC is unlikely to be simply glucocorticoid because responsive patients had severe prednisone side effects at the beginning of treatment, which dissipated as prednisone was withdrawn.
- April 1981 Neurology (Ny) 31 (2) Page 154