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Introduction
The pH of blood is kept stable within extreme narrow margins by a very
intricate basal function of the organism. Through millions of years of
evolution, this basal function has been significantly developed in mammals,
and is considered to be one of the most advanced physiological functions in
man. The use of energy (oxidative processes) is always accompanied by the
production of acids, through which the pH will be lowered. The intricate
basal function is brought about by the interaction of kidneys, lungs, gut and
skin, which will usually excrete the surplus of acidity. But, in cases of
chronic disease, each biological system can be exhausted, including the
acid-base equilibrium. In case of chronic viral infections and cancer, a
depletion of the bicarbonate buffer can add to the catabolism and fatigue of
the chronically ill. Thus, becoming a major risk factor for morbidity and
mortality.
(Chronic) Inflammatory processes and metabolic processes in
cancerous cells are associated with the generation of free oxygen radicals
(FOR). Rusu et al. found that procaine (and its metabolite
diethylaminoethanol DEAE) inhibits the generation and release of super oxide
anion in a non-enzymatic system (1), and Andreadous et al. found that a
series of ethanol amine derivates inhibit the generation of super oxide anion
radicals in a xantine-xantine oxidase system, the respective products also
having a significant anti-inflammatory action (2).
In normal physiological processes, FOR are released by the respiratory burst
of polymorphonuclear cells (PMN), like neutrophils, macrophages and
monocytes. In chronic disease, as a result of an elevated production of FOR
and / or a depletion of antioxidants, FOR can induce severe alterations of
cell macromolecules, expressed by lipid peroxidation, which leads to
destruction of cells. It is strongly suggested by the work of Dolganiuc et
al., that procaine and DEAE inhibit significantly the release of free
radicals by PMN during a respiratory burst (3).
Tumour cells have a less sufficient metabolism and produce mainly lactate
instead of carbodioxide and water. One could say, that tumour cells do not
?gbreathe?h but ?gferment?h. The normal metabolism of glucose is aerobic and
one molecule of glucose provides 38 molecules of ATP (energy). Under
anaerobic circumstances however, one molecule of glucose will provide only 2
molecules of ATP, and instead of CO2 and H2O, lactate is being produced.
Lactate can accumulate locally and cause pain and discomfort, like in
intermittent claudicatio, or systemically, and cause elevated plasma levels.
Loss of appetite (anorexia) and wasting (cachexia) in cancer and in other
chronic diseases, like HIV infection, can be explained, in part, by the
increased need for glucose and the elevated production of lactate.
Thus, in summary, one could say, that tumour cells have an increased need for
glucose to cover their energy requirements, which are 20 times higher than of
normal cells. As a consequence, an increased use of glucose and a depletion
of glycogen storage in the liver take place, and an abundance of lactate is
consequently being produced. On the long run, the increased lactate
production will deplete the bicarbonate buffer in the blood, bring about pain
and discomfort and will initiate catabolism, which will lead to anorexia and
cachexia.
In the Cologne Model, cancer patients, and patients with other (chronic)
conditions, requiring support to overcome the burden of the negative effects
of increased lactate production, will receive infusions with 400 ml NaCl
(0,9%) with 120 ml NaHCO3 (8,4%), and 5 ml of Procaine 2% added.
- Rusu C, Lupeanu E.: Inhibitory effect of procain, Gerovital and Aslavital on the production of superoxide radical. Romanian J Geront Geriatrics, 10(2); 117-129, 1989.
- Andreadu I, Rekka E, Demopoulos V, Kouronakis P.: Effect of some novel ethylamine and ethanolamine derivates on carrageenan induced inflammation. Correlation with antioxidant activity and structural characteristics. Research Comunic Path Pharmacology, 78(2); 245-248, 1992.
- Dolganiuc A, Radu D, Olinescu A, Vrabiescu A.: Procaine and diethylaminoethanol influence on the release of free oxygen radicals by polymorphonuclear leukocytes in rabbits and humans. Rom Arch Microbiol Immunol 57(1): 23-32, 1998.
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