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document
Ranitidine improves lymphocyte function after severe head injury : results of a randomized , double-blind study . OBJECTIVE To study the immunomodulatory effect of the histamine receptor antagonist , ranitidine , in patients admitted to the intensive care unit after severe head injury . DESIGN Randomized , prospective , double-blind study . SETTING Surgical intensive care unit of a university Level I trauma center . PATIENTS Twenty patients admitted with a Glasgow Coma Scale score of < 10 who were enrolled as part of a prospective , multicenter trial to assess the impact of multiple risk factors and ranitidine prophylaxis on the development of stress-related upper gastrointestinal bleeding . INTERVENTIONS Continuous infusion of ranitidine at 6.25 mg/hr ( n = 9 ) or placebo ( n = 11 ) for a maximum of 5 days . MEASUREMENTS AND MAIN RESULTS Before the patients were enrolled in the study and on completion of treatment , lymphocyte cell-surface antigen expression was determined by flow cytometry ( n = 14 patients ) ; mitogen-stimulated interferon-gamma and interleukin-2 production were measured by enzyme-linked immunosorbent assay ( n = 19 patients ) . Treatment with ranitidine , but not placebo , was associated with a significant increase in CD4+ lymphocytes ( 33 % to 49 % ; p < .05 ) and a significant decrease in CD8+ lymphocytes ( 41 % to 27 % ; p < .05 ) . Also , the mitogen-stimulated interferon-gamma production increased from 121 to 269 pg/mL ( p < .05 ) in patients treated with ranitidine , but not in patients treated with placebo . There were no significant differences in interleukin-2 production or circulating B-cell concentrations between both groups . CONCLUSION This study demonstrates an immunostimulatory effect of the histamine-2-receptor antagonist , ranitidine , both at the cellular and mediator levels in patients after head injury .
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Intervention_Pharmacological
Continuous infusion of ranitidine at 6.25 mg/hr
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Intervention_Control
placebo
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Intervention_Pharmacological
ranitidine
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Intervention_Control
placebo
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Intervention_Pharmacological
ranitidine
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Intervention_Control
placebo
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Outcome_Physical
lymphocyte cell-surface antigen expression
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Outcome_Physical
mitogen-stimulated interferon-gamma
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Outcome_Physical
interleukin-2 production
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Outcome_Physical
CD4+ lymphocytes
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Outcome_Physical
CD8+ lymphocytes
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Outcome_Physical
mitogen-stimulated interferon-gamma production
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Outcome_Physical
interleukin-2 production
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Outcome_Physical
circulating B-cell concentrations
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Participant_Condition
severe head injury :
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Participant_Condition
patients after head injury .