Post-treatment data were collected on a patient who received intraveno
us hydroxypropyl beta-cyclodextrin in a dose of 1.5 g/kg in 1985. Alth
ough no untoward effects were observed in this patient, rarely occurri
ng agitation and pulmonary edema have been noted after injections into
rabbits and dogs, respectively. These complications are analyzed here
on the basis of symptoms and on the effects of hydroxypropyl beta-cyc
lodextrin on the biochemistry of a representative lipid, cholesterol,
which were studied in rats. It is hypothesized that these untoward eff
ects of parenteral hydroxypropyl beta-cyclodextrin are due to complex
formation, with lipid mediators of pathological responses, of which pr
ostaglandins are one example. These mediators normally have brief and
localized functions; if hydroxypropyl beta-cyclodextrin happens to be
injected when these mediator systems are activated, their influence an
d the responses of the organism may be increased.