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Hello,
I am new to this board and have a question regarding Ocular Myasthenia Gravis. I have noticed that patients with Ocular Myasthenia Gravis who are on Prednisone therapy and smoke, or drink more than 4 cups of coffee/soda per day require are larger dosage of steroid therapy(Insensitivity/Resistance?). Is there any relevance to this. I have searched PubMed and could not find anything. I also have tried to find the Link between Tobacco/Nicotine or Caffeine to Prednisone. For metabolism of caffeine/glucocorticoids CYP3A4 is implicated. I am having a harder time finding a link between tobacco/Nicotine and Prednisone. Smoking/Nicotine induce CYP1A2 and CYP2A1 respectively. I have also found that smokers have an Increased TNF-alpha/IL-4 which is thought to increase the number of glucocorticoid (beta) receptors and cause glucocorticoid resistance. I am a 3rd year med student who is interested in Ophthalmology and thought this might be a good research project and would appreciate any advice on this topic.
Thanks
Richard
I am new to this board and have a question regarding Ocular Myasthenia Gravis. I have noticed that patients with Ocular Myasthenia Gravis who are on Prednisone therapy and smoke, or drink more than 4 cups of coffee/soda per day require are larger dosage of steroid therapy(Insensitivity/Resistance?). Is there any relevance to this. I have searched PubMed and could not find anything. I also have tried to find the Link between Tobacco/Nicotine or Caffeine to Prednisone. For metabolism of caffeine/glucocorticoids CYP3A4 is implicated. I am having a harder time finding a link between tobacco/Nicotine and Prednisone. Smoking/Nicotine induce CYP1A2 and CYP2A1 respectively. I have also found that smokers have an Increased TNF-alpha/IL-4 which is thought to increase the number of glucocorticoid (beta) receptors and cause glucocorticoid resistance. I am a 3rd year med student who is interested in Ophthalmology and thought this might be a good research project and would appreciate any advice on this topic.
Thanks
Richard