Pentoxifylline reduces pro-inflammatory and increases anti-inflammatory activity in patients with coronary artery disease--a randomized placebo-controlled study. Effect of Pentoxifylline on inflammatory burden, oxidative stress and platelet aggregability in hypertensive type 2 diabetes mellitus patients. A pilot study of pentoxifylline for the treatment of primary sclerosing cholangitis Randomised investigation of effects of pentoxifylline on left-ventricular performance in idiopathic dilated cardiomyopathy Pentoxifylline in ischemic, hypertensive and idiopathic-dilated cardiomyopathy: effects on left-ventricular function, inflammatory cytokines and symptoms. Double-Blind, Crossover Study of the Clinical Efficacy and the Hemorheological Effects of Pentoxifylline in Patients With Occlusive Arterial Disease of the Lower Limbs Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline: Results of a Randomized Study Pentoxifylline Treatment in Patients with Occlusive Peripheral Arterial Disease. Circulatory Changes and Effects on Prostaglandin Synthesis Beneficial Effects of Pentoxifylline in Patients With Idiopathic Dilated Cardiomyopathy Treated With Angiotensin-Converting Enzyme Inhibitors and Carvedilol: Results of a Randomized Study Pentoxifylline in the Treatment of Intermittent Claudication of the Lower Limbs Intermittent claudication: a double-blind crossover trial of pentoxifylline. The effect of pentoxifylline on reduction of proteinuria among patients with type 2 diabetes under blockade of angiotensin system: a double blind and randomized clinical trial. Use of pentoxifylline as an inhibitor of free radical generation in peripheral vascular disease Beneficial hemorheologic therapy of chronic peripheral arterial disorders with pentoxifylline: results of double-blind study versus vasodilator-nylidrin. Pentoxifylline in severe alcoholic hepatitis: a prospective, randomised trial. Effects of pentoxifylline on inflammatory parameters in chronic kidney disease patients: a randomized trial. The Phosphodiesterase Inhibitor Pentoxifylline as a Novel Adjunct to Antidepressants in Major Depressive Disorder Patients: A Proof-of-Concept, Randomized, Double-Blind, Placebo-Controlled Trial
The balance between different immunological stimuli is essential in the progression and stabilization of atherosclerotic plaques . Immune regulation has been suggested as potential target for the treatment of atherosclerotic disease . We sought to determine whether treatment with pentoxifylline , a phosphodiesterase inhibitor with immunomodulating properties , could reduce the pro-inflammatory response observed in patients with acute coronary syndromes ( ACS ) and increase anti-inflammatory activity . In a double-blind , prospect i ve , placebo-controlled study , 64 patients with ACS were r and omized to receive pentoxifylline 400 mg TID or placebo for 6 months . Analysis of the pro-inflammatory markers , C-reactive protein ( CRP ) , interleukin (IL)-6 , IL-12 , interferon-gamma and tumor necrosis factor (TNF)-alpha and the anti-inflammatory cytokines , transforming growth factor (TGF)-beta1 and IL-10 were done at baseline , 1 and 6 months . Pentoxifylline treatment significantly reduced the adjusted levels of CRP and TNF-alpha compared to placebo after 6 months ( P=0.04 and P<0.01 , respectively ) . IL-12 increase was significantly less pronounced with pentoxifylline ( P=0.04 ) . The levels of the anti-inflammatory cytokine , IL-10 , also declined significantly less in the pentoxifylline group compared to placebo ( P<0.01 ) with a trend towards a higher increase of TGF-beta1 in the former group ( P=0.16 ) . Pentoxifylline reduces pro-inflammatory and increases anti-inflammatory response in patients with ACS and may have beneficial clinical effects on cardiovascular events OBJECTIVES Inflammation and oxidative stress are main culprits behind atherosclerosis in diabetes mellitus . This study explores the effect of add-on Pentoxifylline on inflammatory burden and oxidative stress in hypertensive diabetic patients . RESEARCH DESIGN AND METHODS 60 hypertensive type 2 diabetic , aged > or = 45 years were evaluated for anthropometry , clinical parameters , C-reactive protein , total leukocyte count , erythrocyte sedimentation rate , serum albumin , plasma malondialdehyde , blood reduced glutathione , platelet aggregation and clot retraction profile . With informed consent and r and omization , Pentoxifylline ( 400 mg ) was prescribed to 30 patients orally twice daily with meals as add-on therapy to the st and ard therapeutic regimen for one month . The particular parameters were repeated in 26 patients in control group and 25 patients in Pentoxifylline group who completed the follow up . The study was a r and omized , open , add-on clinical trial with parallel controls . RESULTS At one-month follow-up , in the Pentoxifylline group , there was 20.9 % decrease ( p<0.001 ) in C-reactive protein , 18 % reduction ( p<0.001 ) in erythrocyte sedimentation rate , 11.1 % reduction ( p<0.001 ) in total leukocyte count and 5.8 % increase ( p=0.003 ) in serum albumin .  Pentoxifylline showed 20.2 % reduction in plasma malondialdehyde and 4.6 % increase in blood reduced glutathione level . In therapeutic dose range , Pentoxifylline exerted a significant anti-aggregatory effect and a dose dependent decrease in clot retraction in-vitro but there was no significant change in ex-vivo clot retraction . The control group showed no statistically significant change in parameters assessed . CONCLUSION This study reveals improvements in inflammatory markers , oxidative stress and platelet-aggregation by Pentoxifylline , thus preventing atherosclerosis in diabetes mellitus OBJECTIVE : There is no effective therapy for patients with primary sclerosing cholangitis ( PSC ) . Rats with experimental small bowel bacterial overgrowth develop hepatobiliary injury similar to PSC . The hepatobiliary injury results from peptidoglycan-polysaccharide – mediated activation of Kupffer cells , release of cytokines such as tumor necrosis factor ( TNF-α ) , and is prevented by pentoxifylline . Our aims were to assess the safety and effects of pentoxifylline on symptoms and biochemical liver tests in patients with PSC . METHODS : A total of 20 patients with clinical , cholangiographic , and histological features of PSC of varying severity were treated with pentoxifylline sustained release ( SR ) tablets ( 400 mg q.i.d . ) for ≤1 yr . Serum alkaline phosphatase , aspartate aminotransferase , and bilirubin were monitored every 3 months for 1 year ; serum TNF-α and TNF receptor subtypes I and II were assessed at baseline and 1 year . RESULTS : Of 20 patients , 16 tolerated pentoxifylline and completed the study . Two patients were withdrawn because of severe nausea , and two patients were noncompliant with medication and withdrew . Pentoxifylline did not significantly alter symptoms of fatigue or pruritus , serum liver tests , serum TNF-α or TNF receptor levels . CONCLUSIONS : In the current regimen , pentoxifylline alone does not significantly improve symptoms or liver tests in patients with PSC BACKGROUND There is accumulating evidence that inflammatory cytokines have an important role in the pathogenesis of heart failure . Plasma concentrations of tumour necrosis factor alpha ( TNF-alpha ) are high in heart failure and have been correlated with the severity of symptoms . Pentoxifylline suppresses the production of TNF-alpha . This study aim ed to assess the effects of pentoxifylline on left-ventricular function and functional class in patients with idiopathic dilated cardiomyopathy . METHODS We undertook a single-centre , prospect i ve , double-blind , r and omised , placebo-controlled trial , in which 28 patients with idiopathic dilated cardiomyopathy were assigned pentoxifylline 400 mg three times daily or matching placebo .  Clinical , echocardiographic , and radionuclide assessment s were done at baseline and after 6 months of treatment . Primary endpoints were New York Heart Association ( NYHA ) functional class and left-ventricular function . FINDINGS Baseline characteristics were similar in the two groups . Four patients  died during the study period , all in the placebo group . After 6 months of treatment , the proportion of patients in NYHA functional class I or II was higher in the pentoxifylline group than in the placebo group ( 14/14 vs 10/14 ; p=0.01 ) , and ejection fraction was higher in the pentoxifylline group than in the placebo group ( mean 38.7 % [ SD 15.0 ] vs 26.8 % [ 11.0 ] , p=0.04 ) . At 6 months , TNF-alpha plasma concentrations were significantly lower in the pentoxifylline-treated group than in the placebo group ( 2.1 [ 1.0 ] vs 6.5 [ 5.0 ] pg/mL , p=0.001 ) . INTERPRETATION Our results suggest that pentoxifylline improves symptoms and left-ventricular systolic function in patients with idiopathic dilated cardiomyopathy . These results must be confirmed in larger-scale trials INTRODUCTION Tumor necrosis factor (TNF)-alpha and interleukin-6 ( IL-6 ) are significantly elevated in patients with congestive heart failure ( CHF ) .  Pentoxifylline , a xanthin-derived agent , is known to inhibit the production of TNF-alpha and IL-6 . Recent studies have shown that pentoxifylline produces an increase in ejection fraction , a decrease in left-ventricular chamber size and an improvement in clinical status in patients with idiopathic-dilated cardiomyopathy . Therefore , we studied the effects of pentoxifylline in ischemic , hypertensive and idiopathic-dilated cardiomyopathy . METHODS Primary endpoint was left-ventricular ejection fraction ( LVEF ) assessed by contrast 2D echocardiography . Secondary endpoints were concentrations of TNF-alpha , IL-6 , brain natriuretic peptide , maximal oxygen uptake ( VO(2 max ) ) assessed by cardiopulmonary exercise testing and Minnesota Living with Heart Failure Question naire score or New York Heart Association scale . RESULTS Forty-seven patients ( 31.9 % ischemic , 21.3 % hypertensive , 10.6 % ischemic and hypertensive , 36.2 % idiopathic-dilated cardiomyopathy ) were r and omly assigned to pentoxifylline 600 mg BID ( n=23 ) or placebo ( n=24 ) if they had a compensated CHF with a LVEF less than or equal to 40 % and had taken their st and ard treatment consisting of angiotensin-converting enzyme inhibitors , diuretics and beta-blockers for at least 3 months . Baseline demographic and clinical characteristics of each group were similar . Forty-one patients completed the study protocol and were analysed for primary and secondary endpoints . After 6 months of treatment , LVEF was unchanged in the pentoxifylline group compared with placebo ( 29+/-7 to 33+/-10 % vs. 27+/-9 to 34+/-9 % , respectively , P = NS ) . Also the secondary endpoints did not significantly change during follow-up . CONCLUSION Additional treatment with pentoxifylline is neutral with regard to left-ventricular function , inflammatory cytokines and symptoms in patients with ischemic , hypertensive and idiopathic-dilated cardiomyopathy The effect of a 3 month daily administration of 800 mg pentoxifylline ( Trental 400 bds ) or placebo was assessed under double blind crossover design in 18 patients ( 12 males and 6 females ) with peripheral occlusive arterial disease in respect of painfree walking distance and various hemorheological and hemostasiological variables , platelet aggregation , serum cholesterol and triglycerides . In first treatment period walking distance significantly increased with pentoxifylline by 46 % from baseline 121 ± 15 m and by 4 % with placebo from baseline 134 ± 18 m. Pentoxifylline administration furthermore yielded significant decrease in whole blood and plasma viscosity and significant increase in erythrocyte deformability . This was paralleled by distinct reduction of fibrinogen , platelet aggregation and euglobuline lysis time , also plethysmographic variables showed positive changes pointing to improvement of limb perfusion . The results of the study suggest that treatment of peripheral occlusive vascular disease by a drug improving blood fluidity through correction of hemorheological and hemostasiological factors turns especially promising and beneficial since the action centers finally on the languishing microcirculation in the ischemic tissue Background —Inflammatory immune activation commonly occurs in heart failure and may perpetuate this syndrome . We sought to determine whether the immunomodulating agent pentoxifylline enhances left ventricular function in patients with ischemic cardiomyopathy . We also investigated the effect of therapy on levels of brain natriuretic peptide ( NT-pro BNP ) , C-reactive protein ( CRP ) , tumor necrosis factor-&agr ; ( TNF-&agr ; ) , and the marker of apoptosis , Fas/Apo-1 . Methods and Results —In a single-center , prospect i ve , r and omized , double-blind , placebo-controlled  study , 38 patients with ischemic cardiomyopathy received pentoxifylline 400 mg TID or placebo in addition to st and ard therapy .  Clinical assessment , radionuclide ventriculography , echocardiography , and blood analyses were performed at baseline and after 6 months . There were no differences in baseline characteristics between the groups . Five patients died  ( 4 in the placebo group ) . Pentoxifylline treatment result ed in an improvement in functional class ( P < 0.005 ) and an increase in systolic blood pressure ( P < 0.05 ) and left ventricular radionuclide ejection fraction ( P < 0.05 ) compared with the placebo-treated group . There were reductions in plasma concentrations of CRP , NT-pro BNP , TNF-&agr ; , and Fas/Apo-1 in the pentoxifylline compared with the placebo-treated group . Conclusions —In patients with heart failure due to ischemic left ventricular dysfunction , the addition of pentoxifylline to st and ard therapy results in improvements in clinical status and radionuclide ejection fraction , which are accompanied by reductions in plasma markers of inflammation , prognosis , and apoptosis Pentoxifylline has recently been reported to stimulate in vitro the synthesis of prostacyclin . However it is not known so far whether the drug is able to stimulate prostacyclin synthesis in man also in vivo . In the present study the effects of pentoxifylline on prostagl and in synthesis and several circulatory pa rameters were studied in 10 controls and 10 patients with occlusive arterial disease after acute i.v . and medium term oral treatment .  Prostacyclin ( as 6- keto-PGF1alpha ) and PGE 2 plasma concentrations have been measured together with arterial blood flow , peripheral vascular resistance , platelet aggregation and red blood cell deformability .  Pentoxifylline was found both in healthy sub jects and patients to significantly increase prostacyclin plasma concentration after i.v . treatment . In medium term oral treatment prostacyclin concentration was found to increase only two hours after administration and not 8 hours after . No significant variations in PGE2 plasma concentration were found at any time in both groups . Pentoxifylline significantly enhanced resting and post-ischemic blood flow of the lower limbs and simultaneously decreased peripheral vascular resistance both in healthy subjects and patients . Different grade s of delayed platelet aggregation and increased red blood cell deformability were also ob served . In conclusion results of the present placebo controlled study show that pen toxifylline increases arterial blood flow in patients with occlusive arterial dis ease . Moreover pentoxifylline induces a temporary stimulation of prostacyclin synthesis which can be suggested to contribute to the clinical activity of the drug as far as an antithrombotic effect in terms of inhibition of platelet aggregation is concerned Background —We previously reported beneficial effects of pentoxifylline , a xanthine-derived agent known to inhibit the production of tumor necrosis factor-&agr ; , in patients with idiopathic dilated cardiomyopathy treated with diuretics , digoxin , and ACE inhibitors .  Since then , 3 large clinical trials showed important clinical benefits of & bgr;-blockers in this population . Therefore , we design ed the present study to establish whether in patients with heart failure already receiving treatment with ACE inhibitors and & bgr;-blockers , the addition of pentoxifylline would have an additive beneficial effect . Methods and Results —In a single-center , prospect i ve , double-blind , r and omized , placebo-controlled study , 39 patients with idiopathic dilated cardiomyopathy were r and omized to pentoxifylline 400 mg TID ( n=20 ) or placebo ( n=19 ) if they had a left ventricular ejection fraction < 40 % after 3 months of therapy with digoxin , ACE inhibitors , and carvedilol . Primary end points were New York Heart Association functional class , exercise tolerance , and left ventricular function . Patients were followed up for 6 months . Five patients died ( 3 in the placebo group ) . Patients treated with pentoxifylline had a significant improvement in functional class compared with the placebo group ( P = 0.01 ) , with an increment in exercise time from 9.5±5 to 12.3±6 minutes ( P = 0.1 ) . Left ventricular ejection fraction improved from 24±9 % to 31±13 % , P = 0.03 , in the treatment group . Conclusions —In patients with idiopathic dilated cardiomyopathy , the addition of pentoxifylline to treatment with digoxin , ACE inhibitors , and carvedilol is associated with a significant improvement in symptoms and left ventricular function Pentoxifylline , a methyl xanthine analogue was evaluated for treatment of intermittent claudication in a double-blind placebo controlled parallel group study in seven centers in the United States . Tests were performed on 128 cases , including 42 who took pentoxifylline ( 600 mg by mouth daily , increased stepwise to 1200 mg daily at the end of one month ) and 40 who took placebo for 24 weeks . Twenty-five patients on pentoxifylline and 21 on placebo were dropped from the study for reasons unrelated to the drug . Walking ability on a treadmill was increased significantly after 2 weeks and remained so throughout the study in the pentoxifylline vs. the placebo group . Ability to walk until first experiencing intermittent claudication was a more sensitive index than the maximum ability to walk . The drug did not cause changes in blood pressure or in heart rate . Other than mild nausea , there were no significant side effects The influence of the xanthine derivative pentoxifylline ( ' Trental ' or BL191 ; Hoechst-Roussel ) on exercise tolerance was measured in 38 subjects with stable , severe to moderately severe , intermittent claudication who completed a r and omised , double-blind , placebo controlled , cross-over clinical trial . Patients received placebo tablets or 400 mg slow-release pentoxifylline tablets ( ' Trental 400 ' ) twice a day for one week , followed by three times daily for seven weeks , and then crossed over to receive the alternate preparation for another eight weeks . Claudication distance and walking distance were measured on a treadmill before starting treatment and again at four-week intervals during the trial . At the same times , red blood cell filterability , plasma fibrinogen concentration and blood viscosity , resting and post-ischemic calf muscle blood flow , and the resting and post-exercise ankle/brachial systolic pressure ratio were also measured . In this study , the observed effects of  pentoxifylline treatment were no greater than those of placebo , even though serum levels of pentoxifylline and its hydroxy-metabolite were within the anticipated range . This was shown by a ' therapeutic effect ratio ' of 0.98 for treadmill claudication distance and 0.96 for treadmill walking distance after within-patient analysis at the end of the cross-over ( where a ratio of 1.0 means the test drug and placebo effects are identical ) . These ratios have 95 % confidence limits of 0.72 - 1.34 and 0.74 - 1.25 , respectively Although blockade of renin-angiotensin system have been cited as the first line of therapy for the management of diabetic nephropathy ( DN ) , however in a substantial number of patients , progression of renal disease are not completely halted by these agents . We have conducted a double blinded clinical trial to assess the additive effect of pentoxifylline on reduction of proteinuria among patients with type 2 DM under blockade of angiotensin system . The dosage of PTX used in our trial was at a low dosage of 400 mg daily and to our knowledge , we did not found article which evaluated the antiproteinuric effect of pentoxifylline in this dosage . One hundred patients with DN and persistent proteinuria despite treatment with losartan and enalapril in at least 3 months before inclusion in the study were r and omly assigned to two groups . Control group ( n=50 , 26 males and 24 females ) received losartan and enalapril , while treatment group ( PTX Group ) ( n=50 , 28 males and 22 females ) was given losartan , enalapril and pentoxifylline 400mg/day for 6 months . At the beginning of the study there were no significant differences in demographic and clinical characteristics of patients including serum creatinine , HbA1c , blood pressure and urinary protein excretion between two groups ( P>.05 ) . In the PTX group , the mean rate of urinary protein excretion have significantly decreased from 616.66 mg to 378.24 after 3 months ( P=.000 ) and to 192.05 mg after 6 months ( P=.000 ) whereas no significant changes were observed in the control group . The beneficial antiproteinuric effect of PTX was not associated to the degree of metabolic control and a reduction of blood pressure . In addition , at the end of study , the mean clearance of creatinine was significantly higher in PTX group ( P=.04 ) . In conclusion , PTX can significantly provide additive antiproteinuric effect and slow the decrease in GFR among patients with type 2 DM under blockade of angiotensin system Summary The effects of an infusion of pentoxifylline 1 g as an inhibitor of free radical generation have been determined in a double-blind placebo-controlled study . Leucocyte-derived free radical generation ( by the superoxide dismutase-inhibitable reduction of ferricytochrome ) , the release of reactive oxygen metabolites ( as plasma oxidant activity ) , unfractionated leucocyte and erythrocyte filterability rates ( using a constant-flow positive-pressure system ) , plasma viscosity , and plasma fibrinogen concentration have been measured in two matched groups of 10 patients with Stage II peripheral vascular disease , before and after treatment .  Transcutaneous oxygen pressure ( PtcO2 ) during treadmill exercise to stress leg circulation was also measured . Leucocyte-derived free radicals were generated during peripheral ischaemia . Pentoxifylline inhibited their generation , blocked the release of reactive oxygen metabolites , and reduced impairment of the filterability rate of unfractionated leucocytes . The improvements were accompanied by significant shortening of the half-time of recovery of transcutaneous oxygen pressure , indicating that ischaemic damage had been contained Pentoxifylline ( Trental 400 mg coated tablets ) and nylidrin HCl 3 mg were compared for clinical efficacy and safety in an 8-week r and omized double-blind trial . The study was conducted in patients with peripheral arterial disease ( Fontaine stage II or III ) , with 30 patients receiving pentoxifylline ( 23 returned for follow-up ) , and 30 patients receiving nylidrin HCl ( 24 returned for follow-up ) .  Efficacy was assessed objective ly in terms of walking performance ( absolute walking time and walking distance on a treadmill ergometer ) and by acral plethysmography . The clear improvement shown for both variables was greater and statistically significant ( p less than or equal to 0.05 ) after treatment with pentoxifylline . Laboratory data provided no evidence to suggest any adverse effect of either treatment . Subjective side effects were reported by six patients in the pentoxifylline group and by three patients in the nylidrin HCl group BACKGROUND Role of corticosteroids in treatment of  severe alcoholic hepatitis ( SAH ) is controversial . Pentoxifylline ( PTX ) , an inhibitor of TNF , has also been shown to decrease short term mortality in SAH . Aim of this study was to evaluate the effect of PTX on short term mortality , renal and hepatic functions in patients with SAH . METHODS Fifty patients with SAH { Maddrey 's Discriminant Function ( DF ) > or = 32 } were prospect ively enrolled . Twenty five patients received  PTX  ( 400 mg orally , three times a day ) , and 25 received placebo for 4 weeks . Serum tumor necrosis factor ( TNF ) was measured in both groups . RESULTS Baseline characteristics of the two groups were similar . At 4 weeks , mortality in PTX group was lower than that in controls { 20 % ( 5/25 ) versus 40 % ( 10/25 ) respectively ; p = 0.216 ; RR 0.5 ; 95 % CI 0.19 - 1.25}. Renal failure was the cause of mortality in 20 % ( 1/5 ) patients in PTX group , and 70 % ( 7/10 ) in controls ( p = 0.11 ) . Significant reduction in urea , creatinine , DF and TNF was noted in PTX group . Reduction in TNF did not correlate with reduction in creatinine or DF . CONCLUSIONS In patients with SAH , PTX leads to a significant improvement in renal and hepatic functions , and a trend towards decreased short term mortality BACKGROUND Pentoxifylline ( PTF ) is a potential therapeutic agent in chronic kidney disease due to its antiinflammatory and antiproteinuric effects that may influence the progression of renal disease . SUBJECTS AND METHODS We conducted a prospect i ve r and omized trial of 91 patients with estimated glomerular filtration rate ( eGFR ) < 60 ml/min , calculated with 4-variable Modification of Diet in Renal Disease ( MDRD-4 ) Study equation . Patients were r and omly assigned to treatment with PTF 400 mg ( twice a day ) ( n=46 ) or to continue their usual therapy ( n=45 ) . Clinical , biochemical and inflammatory parameters were measured at baseline , and at 6 and 12 months of treatment . The objective of the study was to analyze the effect of PTF treatment on inflammatory markers and secondarily the effect on renal disease progression . RESULTS Baseline characteristics were similar in the 2 groups .  High-sensitivity C-reactive protein ( hs-CRP ) , serum fibrinogen and TNF-alpha decreased significantly in patients treated with PTF in comparison with the control group at 12 months ( p=0.002 , p=0.001 and p=0.000 , respectively ) . Median urinary albumin excretion did not decrease with PTF treatment . In the PTF group , there was no significant change in eGFR after 12 months ( from 42.3 ± 10.2 to 44.7 ± 11.3 ml/min per 1.73 m(2 ) ) , whereas in the control group there was a worsening by the end of the study ( from 40.1 ± 12.4 to 35.7 ± 13.4 ml/min per 1.73 m(2 ) ) ( p=0.000 between groups ) . CONCLUSIONS PTF treatment decreases inflammatory markers in chronic kidney disease and stabilizes renal function Background : There is evidence for an association between major depressive disorder ( MDD ) and both inflammatory and phosphodiesterase ( PDE ) pathways . This study aim ed to evaluate the adjunct role of the PDE inhibitor pentoxifylline ( PTX ) , a compound with anti-inflammatory properties , in the treatment of adult patients with MDD . Methods : This was a prospect i ve , 12-week , double-blind study of parallel groups . Eighty adult out patients who met the DSM-IV criteria for MDD participated in the trial . Patients were required to have a baseline Hamilton Rating Scale for Depression ( HAM-D ) score of at least 18 . Patients were allocated r and omly : 40 received escitalopram 20 mg/day plus placebo while the other 40 received escitalopram 20 mg/day plus PTX ( 400 mg b.i.d . ) . Patients were assessed by a psychiatrist at baseline , and 4 , 8 , and 12 weeks after the medication had been started . The serum levels of TNF-α , IL-6 , IL-10 , BDNF , 8-OHdG , and serotonin were measured at baseline and after therapy . Results : After 8 and 12 weeks , the PTX group showed a statistically significantly greater improvement in HAM-D score compared to the control group ( least squares mean difference [ LSMD ] –3.29 , p = 0.000 and LSMD –3.49 , p = 0.000 , respectively ) . Moreover , the PTX group showed a statistically significantly greater reduction in the serum levels of TNF-α , IL-6 , IL-10 , and 8-OHdG along with a statistically significant increase in the levels of BDNF and serotonin in comparison with the control group after the treatment . Conclusion : The findings of this study suggest that PTX could be a promising adjunct to antidepressants in the treatment of MDD patients
No alteration in plasma IL-6 concentration was observed .
Pentoxifylline did not alter BP or plasma IL-6 concentration , but significantly reduced circulating TNF-α and CRP concentrations
INTRODUCTION Pentoxifylline is a xanthine derivative with potential cardiovascular benefits .
AIM To evaluate the impact of pentoxifylline on  blood pressure ( BP )  and plasma TNF-α , C-reactive protein ( CRP ) and IL-6 through a systematic review and meta- analysis of r and omized controlled trials .