I have wrote a simple and easy to read abstract study-like about fibrosis, tos and neurogenic inflammation and ptx+ vit E with references.


Perineural and muscle fibrosis play a large role in TOS (1,2). In regards to others fibrotic deseases, this fibrosis don't seem to be different from others inflammation-induced fibrosis (3, 3b, 4) In fact, all fibrosis are driven by inflammation (5)

Inflammation are driven mostly by citokynes (with growth factors) and neuropeptides (6)

Mast cell and endothelial stabilizer, neuropeptides and cytokines inhibitors have been suggested as a treatment for TOS (3)

"It must be primarily neural involving sensitized nervi-nervorum and communicating with local mast cells, monocytes, and fibroblasts to participate in the micro-inflammatory process that drives the pathology. This involves not only inflammation, but also the accompanying growth factors, which affect nerves, muscles (hence, the frequent scalene hypertrophy), existing fibrosis, (...) to produce the insidious, cumulative, and devastating symptoms typical of NTOS."

"the closest analogous description that I could find in the literature was that of painful hypertrophic scarring, which showed a similar inflammatory neuropeptide distribution and an abundance of growth factors that were also pro-inflammatory (NGF, FGF…), at least in part. "(6a)

This definitely confirm the role of neurogenic inflammation (NI) and his fibrosis in TOS. NI may lead to neuronal disfunction as well.

All fibrosis are similar, however they are specificities in some organs to take into account (7)

In addition, hypertrophy of scalene may be caused directly by this chronic inflammation neuronale (7aa)

"These findings support that focal nerve inflammation is sufficient to cause neuronal discharge changes that are consistent with clinical findings in early CRPS"


Inhibition of the pathways regulated by CTGF*, IGF-1, VEGF,(b)FGF(2)*, PDGF* and TGF-b*, ET-1* and antioxidants have been suggested to provide novel therapeutic approaches for the treatment of fibrosis (7a)(7b)

Evidences

pentoxifylline (PTX) + Vitamin E for TOS :

PTX

- Inhibit inflammatory and fibrogenic citokynes (8)

- Stabilize endothelial (8)

- Reverse peri-neural and post-operative fibrosis, same as TOS fibrosis (9)

- Inhib neuropeptides substance P, PDCF CTGF (8)

- Inhib some "hypertrophic" growth factors : fgf2, et-1 (8)

- Improve blood flow

- Improve oxygenation of tissues

- Prevent clots

- Antioxidant

- Well tolerated at long terme, Only 3-7% stop the drug because side effects (10)

Vitamin e

- defiency linked to more scar
- increase lipid peroxidation
- anti oxidant
- Blood thinner
- Well tolerated

Having a generally healthy life may increase significantly the benefits (anti oxidant et anti inflammatory), no sugar, good sleep.


References :

1 The anterior scalene muscle in thoracic outlet compression syndrome. Histochemical and morphometric studies
http://www.ncbi.nlm.nih.gov/pubmed/3767646

2 Scalene muscle abnormalities in traumatic thoracic outlet syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/2301718

3 THORACIC OUTLET SYNDROME AS A DISORDER OF NEUROGENIC INFLAMMATION
http://www.doctorellis.com/TOS_neurogenic.html

3b TGF-β1 and radiation fibrosis: a master switch and a specific therapeutic target?
http://www.redjournal.org/article/S0...435-1/abstract

4 Pulmonary fibrosis: cytokines in the balance
http://erj.ersjournals.com/content/11/6/1218.full.pdf

5 Cell Injury, Repair, Fibrosis, and Inflammation
http://www2.niddk.nih.gov/Research/S...Liver/IRFI.htm

6 CYTOKINES IN ACUTE AND CHRONIC INFLAMMATION
http://immuneweb.xxmu.edu.cn/ckine-infec.pdf

6a USE OF NEUROPROTECTIVE ADJUNCTS IN NEUROGENIC THORACIC-OUTLET SYNDROME
http://www.doctorellis.com/Lecture.html

7 Current management for late normal tissue injury: radiation-induced fibrosis and necrosis.
http://www.ncbi.nlm.nih.gov/pubmed/17395040

7aa Focal nerve inflammation induces neuronal signs consistent with symptoms of early complex regional pain syndromes
http://cat.inist.fr/?aModele=afficheN&cpsidt=21896157

7a Inhibition of PDGF, VEGF and FGF signalling attenuates fibrosis
http://erj.ersjournals.com/content/29/5/976.full.pdf

7b Antioxidants as potential therapeutics for lung fibrosis
http://www.ncbi.nlm.nih.gov/pubmed/17999627

8 Pentoxifylline in the Treatment of Radiation-Induced Fibrosis
http://jco.ascopubs.org/content/22/11/2207.full

9 Post-operative fibrosis: Pathophysiological aspects and therapeutical perspectives
http://www.sciencedirect.com/science

10 Pentoxifylline side effects
http://www.drugs.com/sfx/pentoxifyll...e-effects.html


And the best : I am on ptx + vit E since 12 days, and i have relief from maybe anti inflammatory effect and blood thinner

No side effect if taken during meal - for the moment.