Prednisone question

[peglem]

Does prednisone suppress antibody production or just decease inflammation? I've never been very clear on that.

[sf_mom]

How does prednisone work?

 

In part, prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. In some illnesses, the immune system produces antibodies, which become overactive and cause undesirable effects. These illnesses are referred to as "autoimmune diseases". Prednisone suppresses the production of antibodies. This suppression can make it slightly harder for you to fight off infection but also stabilizes the immune system if it is overactive.

 

Prednisone also works against inflammation to reduce the heat, redness, swelling and pain.

 

When beginning prednisone, there is a small chance that it may cause serious increased weakness for a short period of time. Therefore, it may be necessary for you to be hospitalized for the first few days for observation.

[peglem]

How does prednisone work?

 

In part, prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. In some illnesses, the immune system produces antibodies, which become overactive and cause undesirable effects. These illnesses are referred to as "autoimmune diseases". Prednisone suppresses the production of antibodies. This suppression can make it slightly harder for you to fight off infection but also stabilizes the immune system if it is overactive.

 

Prednisone also works against inflammation to reduce the heat, redness, swelling and pain.

 

When beginning prednisone, there is a small chance that it may cause serious increased weakness for a short period of time. Therefore, it may be necessary for you to be hospitalized for the first few days for observation.

Well, I guess I was looking for something more specific- I mean, suppressing inflammation would be a suppression of an immune reaction. But does it suppress antibody production in particular? I'm trying to decide whether to give it right now- while I think my daughter has some kind of bug surfacing- She'll be on rifampin and augmentin at the same time, but, though I'd like the autoantibodies suppressed, not so sure I want all antibodies suppressed.

While I'm here- does it suppress the function of antibodies that are already in circulation (like from IVIG, say) or just reduce the production of new antibodies?

[Kayanne]

For me, that is the million dollar question. The correct way to time the prednisone, while still making sure the body can fight the infection. I remember asking a doctor (can't remember if it was the ped or Dr. L.) how soon before pred suppressed the immune system, and the answer was right away.

 

As you know, we've had great success with 2 prednisone monthly tapers. The first time, her strep was cleared a couple of weeks prior with clindamycin, and the second time she was prescribed 10 days of Omnicef by one of her peds before we took her to Dr. L. Each time, she was given about 10 days antibiotics prior to starting the pred.

 

I actually believe that this is one of the reasons we've had good success with the pred--the infection gets addressed first. I should add that my daughter has no evidence of any immune issues--other than her PANDAS.

[dcmom]

Kayanne-

 

I agree.

 

SF mom's post seems to indicate that it would supress all antibodies, not just auto antibodies. That being said, while it would inhibit antibody creation, I have been told by our doc it takes longer than a 4 week taper to really become "immunosuppressed".

 

I would think timing is important. I think it might be best to wait until she is recovered from the illness- but not for long.

 

My younger dd had H1N1 for which we did Tamiflu. Tamiflu really halted the flu. Twelve hours after her fever subsided, she was spiraling down into a pretty severe pandas episode. We waited for 2 days to make sure we weren't jumping the gun, but it was clear she was going off of a cliff. We then started the month long pred taper- so that was about 3 days after the fever was done. It worked like a charm.

 

Don't you always feel like you are walking a tightrope?

 

My older one has a bad cold now, I am afraid to get her up in the mornings, for fear of pandas resurfacing

[Kayanne]

SF mom's post seems to indicate that it would supress all antibodies, not just auto antibodies. That being said, while it would inhibit antibody creation, I have been told by our doc it takes longer than a 4 week taper to really become "immunosuppressed".

 

I know I've been told that too, by both the ped and Dr. L. -- that is one of the reasons you don't want to go too far out past a month because that is when the real side effects start. So I guess like most things, the process starts right away, but doesn't fully kick in for a while.

[peglem]

This would only be the 5 days. We've never done longer than the 5 day. The 1st time we did it, though, she got sick w/ a high fever on the last 2 days and the week after. Its not like she makes tons of her own antibodies anyway. And that's something that I don't quite get- how is she so efficient at making the autoantibodies, but not the regular ones.