School of Medicine

Answer:  Theophylline belongs to the same family of drugs as caffeine and just like caffeine, theophylline is found naturally in coffee, tea and cocoa.  We all know that coffee is a natural stimulant that can help keep us awake and more alert.  This happens because nerve cells in the brain are stimulated by the drugs that are in coffee.

When theophylline is taken as a pill or when the doctor administers the drug intravenously, the concentrated medicine works in much the same way by actually stimulating different types of nerve cells in the brain.

The nerve cells in the brain that control breathing are one of the types of cells that theophylline stimulates.  When these cells are stimulated, the impulses are increased over the pathway connecting the brain cells with the spinal cord cells that make the respiratory muscles contract.  Thus, the theophylline-induced increase of respiratory command impulses down into the spinal cord from the brain activates previously latent connections between the brain and spinal cord centers that control breathing.  The result is recovery of respiratory muscle function.

If you want more detailed information, please consult one of our studies:  Nantwi and Goshgarian, Neuropharmacolgy 37:113-121, 1998.

Question:  What type of patient are you looking for to participate in your clinical studies involving theophylline?

Answer:  The patient should be between 18 and 65 years old, have a documented mid to high (C2-C6) cervical spinal cord injury with some breathing insufficiencies and be in stable clinical condition.  Breathing insufficiencies could include, but are not limited to, shortness of breath, difficulty in coughing or clearing mucus secretions from the respiratory passages.  Presently, we are seeking patients who are not ventilator-dependent, but we will be including ventilator-dependent patients in the future.

Question:  What criteria would exclude a patient from the clinical study?

Answer:  A patient would not be an acceptable subject for our clinical study if the patient sustained a spinal cord injury within the last three months; had a history of active lung, heart, kidney or liver disease; or had a documented intolerance to theophylline.

Question:  Will other medications that I may be taking affect theophylline's effectiveness in improving muscle function?

Answer:  Generally no, but a select few antibiotics and the medication dilantin (a medication to control seizures) should not be taken with theophylline. We ask that all patients inquiring about participating in the study provide us with a list of medications that they will be taking at the time of the study.

Question:  Are there any side effects of theophylline?

Answer:  If taken in very high does, theophylline could cause nervousness, insomnia, cardiac arrhythmias or seizures.  We carefully monitor the amount of drug given to the patient during the procedure to insure that the drug is delivered in safe amounts at therapeutic levels.  Some people experience an upset stomach and nausea with theophylline that is usually lessened if it is taken with food. Thus, although there is some potential risk, the risk is quite small compared to the potential benefits that may be realized by the patient.

Question:  If a patient lives outside of Michigan, can they participate in your clinical studies? 

Answer:  Yes.   We have no geographical limitations imposed on the subjects that we accept in our Michigan-based studies.  However, we do not have the resources to reimburse patients for travel expenses incurred by the patient to travel to Michigan for the testing procedures. We can, however, provide free hotel accommodations and a food allowance during your visit to Detroit for the testing. Our current study requires 4 visits to the VA hospital in Detroit, Michigan spaced out at about 6-week intervals. The visits only last 1-2 hours.

Question:  Is theophylline an experimental drug and how expensive is it?

Answer:  Theophylline is not an experimental drug.  It has been used clinically for decades in the treatment of lung diseases such as asthma, bronchitis and chronic obstructive pulmonary disease (COPD).  There are many drug companies that manufacture theophylline and it is relatively inexpensive.  We will provide the patient with all the theophylline needed during the clinical study at no cost to the patient.