Cyclosporine A sensitivity in vitro and P-glycoprotein expression in patients on dialysis and after kidney transplantation

Zacher, Thorsten; Thiele, Bernhard; Waßmuth, Ralf; Albert, F. W.

doi:10.1016/s0966-3274(00)00018-6

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Hence, the over-expression of functional P-gp molecules in lymphocytes possibly results in the unresponsiveness of cells to immunosuppressive drugs. However, the association of up- Increased GR beta expression [162] Activated NF-kappa B and I-kappa B alpha GCs P-gp over-expression [164] regulation of P-gp in PBMCs of the recipients of solid organ transplantation with clinical drug resistance of the recipients is controversial [128][129][130].…”

Section: Organ Transplantationmentioning

confidence: 99%

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

Hirano

2007

International Immunopharmacology

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Section: Organ Transplantationmentioning

confidence: 99%

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

Hirano

2007

International Immunopharmacology

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“…It revealed that sensitivity to CsA has inter-individual difference, and is higher in transplant recipients than in normal controls. While the molecular description for finding is not comprehended, it seems to be isolated from genetic (96). Very different genetic markers such as HLA, POR*28 allele, ABCB1, NFKB1, and many more genotypes (97-99) play a great role in disease and CsA level (98,100), which seem to be of clinical significance.…”

Section: Individualizing Target Range and Adjusting Dose Of Cyclosporinementioning

confidence: 99%

A Systematic Review about an Advance in Cyclosporine Monitoring in Kidney Transplant Recipients

Einollahi

Teimoori

2017

Nephro-Urol Mon

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Context: An immunosuppressive drug, Cyclosporine (CsA), has been commonly used in kidney transplants. A safe dosing of CsA often causes nephrotoxity, bone marrow toxicity, and infection. Pharmacokinetic characteristics of CsA and CsA marker relation to the immune suppression have not been completely described in clinical practices yet. Objectives: This review summarizes our achievements on pharmacokinetic and CsA level Marker in kidney transplant patients. Search methods and Selection criteria: A literature review was done using the National Center for Biotechnology Information's Pubmed Medline, Ovid Medline and Embase, and Iranian registries (Iranmedex, SID, MagIran, and IranDoc). Titles and abstracts were then reviewed to select studies based upon the predefined inclusion criteria. Our study defined a population of adult solid organ transplant recipients receiving the cyclosporine that Cyclosporine monitoring was done. Data Collection and Analysis: Two reviewers independently appraised the quality of each trial and extracted the data from the included trials. Results: CsA pharmacokinetics is very different between kidney transplant recipients, in order to CsA profiling, no pharmacodynamic tools has been confirmed yet in clinical practices and the best way to individualize calcineurin inhibitor therapy is still a controversial issue. C0 levels do not exactly predict the CsA level or rejection risk, patient monitored by C2 levels have upper doses of CsA and have a lower frequency of early acute allograft rejection than patients profiled with C0 and although CA is highly heterogeneous closely post-transplant and seems to be unhelpful early after post-transplant it is more favorable after first months after. Conclusions: Establishing a biological CsA marker may be helpful in clinical decisions on the dose. It seemed to be logical that we should re-inspect the possibility of using them as a supplementary tool towards better therapeutic drug monitoring of cyclosporine or it needs to be reevaluated and needs to find a new target for a therapeutic plan in kidney transplant patients.

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New concepts in cyclosporine monitoring

Keown

2002

Current Opinion in Nephrology and Hypertension

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Single-point C2 monitoring can be implemented quickly and simply with appropriate site and patient training. The timing of phlebotomy is more critical, but immunoassay bias is lower with 2 h post-dose than with trough level measures. Single-point C2 monitoring may be effective in liver and heart replacement, but initial target levels for liver transplantation are lower because cyclosporine is transported directly to the liver via the portal system. C2 monitoring is now being widely adopted as an accurate and practical measure of drug exposure, and can be combined with pharmacodynamic methods to optimize immunosuppression.

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Cyclosporine A sensitivity in vitro and P-glycoprotein expression in patients on dialysis and after kidney transplantation

Cited by 4 publications

References 12 publications

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

Cellular pharmacodynamics of immunosuppressive drugs for individualized medicine

A Systematic Review about an Advance in Cyclosporine Monitoring in Kidney Transplant Recipients

New concepts in cyclosporine monitoring

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