Do Calcium Channel Blockers Have Any Influence on the Immunological Status of Renal Graft Recipients on Ciclosporin Therapy?

Abstract

We have assessed the peripheral distribution of T cells, using the monoclonal antibodies OKT3, OKT4, OKT8 and LEU7 and the proliferative response to phytohaemagglutinin (PHA), in 10 renal transplant recipients. In each patient, the immunological pattern was evaluated twice, both before and after 1 month of calcium antagonist (calcium channel blockers, CaA) treatment. During treatment with CaA, we have observed both a significant decrease in the mitogenic response to PHA and a significant increase in OKT8 cells. Our data support the hypothesis that CaAs per se may have an immunomodulatory effect on T cell distribution independently of changes in ciclosporin (CS) blood levels. These results could also provide a cellular basis for synergism between CS and CaA.

Acute Kidney Graft Rejection Morphology and immunology

“…All transplanted patients in our material received azathioprine, prednisolone and cyclosporin and in one study also a calcium canal blocking agent (Diltiazem). The latter did not influence rejection episodes or graft outcome which has been described in some reports (40,161,138), and we were unable to detect any changes on morphology which could be attributed to the calcium canal blocking agent (I,). Furthermore, a calcium blocker did not influence the expression of MHC class I and class I1 antigens or ICAM-1 on cultured human tubular cells (IV).…”

Macrophages and Lymphocyte Subpopulations in Nifedipine‐ and Cyclosporin A‐Associated Human Gingival Overgrowth

“…9,16 Impairment of T-cell proliferation by calcium channel blockers could partly result from interference with functioning of accessory cells; e.g., in relation to production of interleukin-1. 18 Calcium channel blockers have a synergistic immunosuppressive effect when CsA therapy is given 19,20 and an additive effect on CsA-induced suppression of T-cell proliferation. 21 Mandreoli et al 20 suggested that calcium channel blockers per se had immunomodulatory effects on T-cell distribution in peripheral blood, independent of changes in CsA blood levels.…”

Calcium channel blockers for preventing acute tubular necrosis in kidney transplant recipients

“…In addition, the studies use a variety of calcium channel blockers from di erent classes, given by di erent routes over di erent time periods. The issue is further clouded by the fact that some calcium channel blockers (especially diltiazem) may exert an immunosuppressive e ect (Mandreoli 1990;McMillen 1985). Diltiazem interacts with cyclosporin and cyclosporin A pharmacokinetics and lower doses of these immunosuppressive drugs can be given to obtain therapeutic levels (Chrysostomou 1993;Morris 1998).…”