Dyslipidemia can reduce the immunosuppressive effects of cyclosporine

Pozzetto, U; Citterio, Franco; Fioravanti, Gilda; Navarra, Pierluigi; Boccalini, Francesca

doi:10.1016/j.trim.2007.10.002

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…Lowering of low-density lipoprotein receptors in lymphocytes may inhibit the low-density lipoprotein-cyclosporine complex and suppress cyclosporine activity, which may result in chronic changes in graft kidney. 18,19 Low-density lipoprotein levels were significantly higher in 34 Chronic hepatitis C virus (HCV) infection is an independent risk factor for CAD, which may be the result of hyperimmunization and increased acute rejection episodes in HCV-positive kidney transplant recipients. In our study, we found that 12 of 13 HCVpositive patients had an acute rejection episode in the first year after kidney transplant, and all patients were in the IF/TA-positive group.…”

Section: Discussionmentioning

confidence: 99%

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Canver²,

Demirci³

et al. 2017

Exp Clin Transplant

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Objectives: Chronic allograft dysfunction is a complex and multifactorial process characterized by progressive interstitial fibrosis and tubular atrophy. The finding of interstitial fibrosis and tubular atrophy is prevalent among kidney transplant patients receiving a calcineurin inhibitor-based immunsuppressive regimen and may be considered as a surrogate of allograft survival. Both immune (acute rejection episodes, sensitization, and HLA incompatibility) and nonimmune (donor age, delayed graft function, calcineurin inhibitor toxicity, infections, and hypertension) mechanisms play a role in chronic allograft dysfunction, and different causes all lead to similar histologic and clinical final pathways, with the end result of graft loss. In our study, we aimed to compare the outcomes of kidney transplant recipients with or without interstitial fibrosis and tubular atrophy in protocol biopsies to determine the conditions that may affect allograft survival. Materials and Methods: We divided 192 kidney transplant recipients into 2 groups (96 patients with interstitial fibrosis and tubular atrophy; 96 patients without interstitial fibrosis and tubular atrophy) according to protocol biopsy at 6 months. Patient groups were compared according to their risk factors for chronic allograft dysfunction (cold ischemia time, delayed graft function, donor age, infections, mean blood calcineurin levels, and hypertension). Results: Cold ischemia time, delayed graft function, high 24-hour proteinuria levels, and higher mean blood calcineurin levels were found to be major risk factors for poor graft function in kidney transplant recipients with interstitial fibrosis and tubular atrophy. Renin-angiotensin system blockage with either angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was found to be preventive for interstitial fibrosis and tubular atrophy after kidney transplant. Conclusions: Preventing prolongation of cold ischemia time, lowering blood cholesterol levels, angiotensinconverting enzyme inhibitors and angiotensin receptor blocker treatment even without existing proteinuria and avoiding higher doses of calcineurin inhibitors should be major approaches in kidney transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Untitled

Sayın

Canver²,

Demirci³

et al. 2017

Exp Clin Transplant

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“…Thus dyslipidemia induced by immunosuppressants tends to decrease the effect of immunosuppressant by decreasing its availability and leading to graft loss (Pozzetto et al, 2008). Hence dyslipidemia has to effectively be managed to prevent graft survival rates and reduce the risk of cardiovascular mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Dyslipidemia decreases the availability of intracellular cyclosporine concentration available to inhibit the immune activation process and thereby contributes to chronic allograft loss (Pozzetto et al, 2008). Thus dyslipidemia induced by immunosuppressants tends to decrease the effect of immunosuppressant by decreasing its availability and leading to graft loss.…”

Section: Introductionmentioning

confidence: 99%

A Study on Immunosuppressant Induced Dyslipidemia and Associated Chronic Graft Rejection in Renal Transplant Recipients

George¹,

Dhivya²

2016

J App Pharm Sci

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Dyslipidemia is a common complication of renal transplantation referred to as new onset dyslipidemia. Immune suppressants, in particular cyclosporine, the calcineurin inhibitor and others are known to cause dyslipidemia through non-competitive inhibition of sterol 27-dehydroxylase (CYP27A1). On the other hand, dyslipidemia has been found to be associated with higher graft rejection due to decrease in immune suppressant activity and direct graft destruction. Hence the study was designed to analyze the effect of dyslipidemia on chronic allograft rejection. Clinical and biochemistry reports of 142 renal transplant recipients were collected in designed case report forms. All statistical analysis was carried out using International Business Machine (IBM) Statistical Package for Social Sciences (SPSS) 17.0. Immunosuppressive therapy, comorbid diabetes and hypertension, age and serum creatinine were found to be the common predictors of dyslipidemia whereas as dyslipidemia, age and gender were found to be predictors of graft destruction and loss (P>0.05). Incidence of graft loss was found higher in dyslipidemic patients (P<0.05). Dyslipidemia is associated with higher incidence of graft loss and hence renal transplant recipients should be effectively managed with dose intense statin therapy or other safer immunosuppressants. This could increase graft survival rates.

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Dyslipidemia can reduce the immunosuppressive effects of cyclosporine

Cited by 2 publications

References 18 publications

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A Study on Immunosuppressant Induced Dyslipidemia and Associated Chronic Graft Rejection in Renal Transplant Recipients

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