      Document 0167
 DOCN  DRG0167
 UNIQUE IDENTIFIER        DRG-0080
 NAME OF SUBSTANCE        Dinitrochlorobenzene [Int Conf AIDS 1992 Jul
                          19-24;8(2): (abstract no PoB 3461)]
 REGISTRY NUMBER          97-00-7
 STANDARD CHEMICAL NAME   1-chloro-2,4-dinitrobenzene [Merck Index
                          1989]
 SYNONYMS                 DNCB [The Extra Pharmacopoeia 1993]
 SYNONYMS                 2,4-Dinitrochlorobenzene [The Extra
                          Pharmacopoeia 1993]
 PROTOCOL ID NUMBERS      FDA 047A
 SECONDARY SOURCE ID      DRG
 PHARMACOLOGICAL ACTION   MODE OF ACTION: Dinitrochlorobenzene (DNCB)
                          is a contact sensitizing agent that enhances
                          the function of antigen-presenting cells
                          (APCs) via induction of delayed-type
                          hypersensitivity. Topical application of DNCB
                          was previously shown to be safe in a small
                          number of patients with early HIV disease.
                          One study has followed the clinical course
                          and examined alterations of lymphocyte
                          subsets in this same group of patients over a
                          longer period of time. The researchers
                          concluded that prolonged use of topical DNCB
                          is associated with a stable clinical course
                          in most patients, despite a significant
                          decrease in CD4 T-cells. Lack of disease
                          progression is associated with a stable CD8
                          CD38 count, and may be related to a
                          persistent increase in natural killer cells.
                          This increase is probably due to DNCB-induced
                          delayed-type hypersensitivity that may be
                          beneficial in HIV disease. DNCB also appears
                          to be effective in the treatment of cutaneous
                          Kaposi's angiosarcoma. In 13 patients
                          receiving topical DNCB over 14-44 months
                          increases in natural killer cells and
                          activated/cytotoxic CD8-T cells were noted.
                          In the same study, in noncompliant patients,
                          these cellular immune related lymphocyte
                          subsets decreased. [Int Conf Aids 1992 Jul
                          19-24;8(2): (abstract no. PoB 3461)] [J Am
                          Acad Dermatol 1994 Sep;31(3Pt2)] [ImmunoFacts
                          1993]
 DISEASES STUDIED/TREATED Local treatment for cutaneous Kaposi's
                          angiosarcoma [Int Conf AIDS 1992 Jul
                          19-24;8(3): (abstract no. PuB 7361)]
 DISEASES STUDIED/TREATED Stimulation of the immune system [Int Conf
                          AIDS 1992 Jul 19-24;8(2): (abstract no PoB
                          3461)]
 CLASSIFICATION CODE      Immunomodulator [Int Conf AIDS 1992 Jul
                          19-24;8(2) abstract no PoB 3461]
 CLASSIFICATION CODE      Contact allergen [Arch Dermatol, April
                          1988;12]
 OTHER MAJOR USES         Test for cellular immunity in patients with
                          neoplastic and immunologic disorders.
                          Treatment of alopecia areata and persistent
                          verruca vulgaris [The Extra Pharmacopoeia
                          1993]
 SUBSTANCE INTERACTIONS   Cross-reacts with chloramphenicol. [Br Med J
                          1976;2]
 ADVERSE EFFECTS          Treated areas have become erythematous and
                          bullous, with pruritis and burning. A 10%
                          adverse reaction rate was reported following
                          topical DNCB in patients with early HIV
                          disease. [Int Conf AIDS 1992 Jul 19-24;8(3):
                          (abstract no. PuB 7361)] [Immunology Letters
                          1993 Apr;36(1)]
 CONTRAINDICATIONS        Contraindicated in patients with benign
                          dermatoses. [Arch Dermatol 1985]
 CHEMICAL/PHYSICAL DATA   MOLECULAR WEIGHT: 202.56 [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   MOLECULAR FORMULA: C6H3ClN2O4 [Merck Index
                          1989]
 CHEMICAL/PHYSICAL DATA   PHYSICAL DESCRIPTION: Yellow crystals [Merck
                          Index 1989]
 CHEMICAL/PHYSICAL DATA   MELTING POINT: 52-54 C [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   ELEMENTAL COMPOSITION: C35.57%, H1.49%,
                          Cl17.50%, N13.83%, O31.60%
 CHEMICAL/PHYSICAL DATA   SOLUBILITY: Practically insoluble in water;
                          sparingly soluble in cold alcohol, freely
                          soluble in hot alcohol; soluble in ether,
                          benzene, CS2 [Merck Index 1989]
 CHEMICAL/PHYSICAL DATA   DRUG DESCRIPTION: A contact sensitizing agent
                          [Int Conf AIDS 1993 Jun 6-11;9(1)]
                          [ImmunoFacts 1993]
 SUBSTANCE DELIVERY DATA  DOSAGE FORM: 2% solution of DNCB in acetone.
                          [Int Conf AIDS 1992 Jul 19-24;8(3): (abstract
                          no PuB 7361)] [ImmunoFacts 1993]
 SUBSTANCE DELIVERY DATA  MODE OF DELIVERY: Topical. [Int Conf AIDS
                          1992 Jul 19-24;8(3): (abstract no PuB 7361)]
                          [ImmunoFacts 1993]
 REFERENCES               Stricker RB, Elswood BF, Goldberg B, Dumlao
                          C, Van Elk J, Henry J, Winger EE, Epstein WL.
                          Clinical and immunologic evaluation of
                          HIV-infected patients treated with
                          dinitrochlorobenzene. J Am Acad Dermatol.
                          1994 Sep 31(3 Pt 1):462-6.
 REFERENCES               Traub A. Use of DNCB as a immune modulator in
                          HIV positive patients--a pilot study. Int
                          Conf AIDS. 1994 Aug 7-12;10(1):219 (abstract
                          no. PB0304).
 REFERENCES               Stricker RB, Elswood BF. Delayed-type
                          hypersensitivity and AIDS [letter; comment].
                          Ann Inter Med. 1994 Feb 15;120(4):343-4.
 REFERENCES               Stricker RB, Elswood BF, Goldberg B, Dumlao
                          C, Van Elk J, Berger TG, Epstein W. Analysis
                          of lymphocyte subsets in HIV-infected
                          patients treated with topical
                          dinitrochlorobenzene (DNCB). Int Conf AIDS.
                          1993 Jun 6-11;9(1):492 (abstract no.
                          PO-B28-2140).
 REFERENCES               Stricker RB, Zhu YS, Elswood BF, Dumlao C,
                          Van Elk J, Berger TG, Tappero J, Epstein WL,
                          Kiprov DD. Pilot study of topical
                          dinitrochlorobenzene (DNCB) in human
                          immunodeficiency virus infection. Immunol
                          Lett. 1993 Apr;36(1):1-6.
 REFERENCES               Stricker RB, Elswood BF. Topical
                          dinithrochlorobenzene in HIV disease. J Am
                          Acad Dermatol. 1993 May;28(5 Pt 1):796-7.
 REFERENCES               Stricker RB, Zhu YS, Gong Y, Dumlao C, Van
                          Elk J, Elswood BF, Berger TF, Tappero J,
                          Epstein WL, Kiprov DD. Pilot study of topical
                          dinitrochlorobenzene (DNCB) in HIV disease:
                          clinical features and molecular correlates.
                          Int Conf AIDS. 1992 Jul 19-24;8(2):B163
                          (abstract no. PoB 3461).
 REFERENCES               Micheletti GA Jr, Adams A, Garland J, Stool
                          E, Gathe J Jr, Manner C. Topical treatment of
                          cutaneous Kaposi's angiosarcoma with DNCB.
                          Int Conf AIDS. 1992 Jul 19-24;8(3):109
                          (abstract no. PuB 7361).
 REFERENCES               Stricker RB, Elswood BF, Abrams DI. Dendritic
                          cells and dinitrochlorobenzene (DNCB): a new
                          treatment approach to AIDS. Immunol Lett.
                          1991 Aug;29(3):191-6.
 ENTRY MONTH              9003
 LAST REVISION DATE       960314
 

SOURCE: National Library of Medicine, Bethesda, MD.  Distributed by AEGIS.
