Effects of cyclosporine in recent-onset juvenile type 1 diabetes: Impact of age and duration of disease

Stiller, C. R.; Dupré, J.; Gent, Michael; Heinrichs, Daniel; Jenner, M.; Keown, P. A.; Laupacis, Andreas; Martell, R.; Rodger, N. W.; Wolfe, B. M.; Mahon, Jeffrey L.

doi:10.1016/s0022-3476(87)80058-6

Cited by 29 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In such patients, treatment with an anti-CD3 monoclonal antibody led to a reduced insulin requirement that lasted 2 years [Herold et al, 2002;Herold and Taylor, 2003]. Similar results were obtained with cyclosporine [Stiller et al, 1987;DeFilippo et al, 1996].…”

Section: Pancreas Transplantationmentioning

confidence: 54%

Insulin: moments in history

Rendell

2008

Drug Development Research

View full text Add to dashboard Cite

The isolation of insulin by Banting and Best in 1922 was a historic event of life-saving importance. Thousands of individuals doomed to die of type I diabetes were saved. The inspiring story of insulin continued to grow and evolve with the development of PZI, NPH, and lente insulins. The advent of production of human insulin from recombinant DNA brought an end to the extraction of insulin from animal pancreas. Modification of the amino acid sequences of insulin led to new forms of fast-acting insulin, such as lispro, aspart, and glulisine, and to long-acting insulins like glargine and detemir. The technology of insulin pumps advanced from large, cumbersome equipment to present-day devices no bigger than a hand calculator. The accuracy of implantable glucose sensors improved progressively, culminating in the approval of devices that will soon exert reliable feedback control of insulin pumps. Transplantation of the pancreas offers a cure for type I diabetes, and the development of islet cell transplantation continues. It is now appreciated that islet cells regenerate in the normal pancreas, and islet cell neogenesis agents have been identified and may eventually contribute to the reversal of diabetes. Drug Dev Res 69:95-100, 2008.r2008 Wiley-Liss, Inc.

show abstract

Section: Pancreas Transplantationmentioning

confidence: 54%

Insulin: moments in history

Rendell

2008

Drug Development Research

View full text Add to dashboard Cite

show abstract

“…Moreover, the chances of remission were greater in patients aged 16 years or more at entry, by comparison with younger patients. Yet lower rates of remission were observed in a further group of younger patients, ranging in age from 22 months to 8 years at entry [5]. The clinical outcome did not correlate with the basal or stimulated C peptide level in the plasma at entry, or with the presence or absence of islet cell antibodies in the blood.…”

Section: Effects Of Ciclosporin In the Clinical Remission Phase Of Iddmmentioning

confidence: 76%

Induction and Pathophysiology of Remission of Insulin-Dependent Diabetes Mellitus during Administration of Ciclosporin

et al. 1990

Self Cite

View full text Add to dashboard Cite

Ciclosporin-induced noninsulin-receiving remissions in insulin-dependent diabetes mellitus are associated with enhancement of beta-cell function. Patients in remission show virtually no insulin responses to parenteral glucose, contrasting with substantial responses to mixed meals, indicating effects of nonglucose nutrients and/or enteroinsular mechanisms. Remission is associated with normal insulin sensitivity; loss of insulin sensitivity can lead to relapse. The risks of the treatment call for studies with lower doses, and it is argued that a continuing search for immunomodulatory interventions that enhance and preserve the clinical remission-phase characteristics should be pursued.

show abstract

“…Although spontaneous remissions of Type I diabetes have been demonstrated, cyclosporine therapy usually only provides a 'honeymoon phase' away from insulin therapy (5,6). In contrast, others have suggested that cyclosporine immunosuppression aggravates the diabetic state (13)(14)(15)(16)(17)(18); both hyperglycemia (14) and hypoinsulinemia (13) have been associated with the use of cyclosporine, most likely due to direct cyclosporine-induced degranulation of pancreatic beta-cells (13).…”

Section: Discussionmentioning

confidence: 99%

“…Cyclosporine, a T-ce}J-specific immunosuppressant, has recently undergone extensive trials in the prevention and treatment of Type I insulin-dependent diabetes (4)(5)(6)(7). However, the use of cyclosporine has been limited by serious toxicities to the liver and kidney, as well as seizures, hypertension and metabolic disorders (8).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cyclosporine pharmacokinetics and effect in the Type I diabetic rat model

Brunner

Iyer

Vadiei

et al. 1989

Eur. J. Drug Metab. Pharmacokinet.

View full text Add to dashboard Cite

Recent clinical studies have demonstrated the potential benefit of the T-cell-specific immunosuppressant, cyclosporine, in the treatment of Type I insulin-dependent diabetes. In the present study, steady-state cyclosporine pharmacokinetics, fasting glucose and insulin levels and renal function were examined in stable insulin-dependent diabetic rats and compared to non-diabetic rats. Mean creatinine clearance 30 days following diabetes induction was not significantly different from saline controls. Cyclosporine treatment (5 mg/kg/day i.v. for 13 days) did not significantly alter creatinine clearance in either group; however, renal function of vehicle-treated diabetic rats was markedly reduced compared to other groups. Serum insulin concentrations were significantly greater in diabetic rats treated with cyclosporine compared to the control group (35.1 +/- 22.7 vs. 16.0 +/- 8.1 microU/ml; P less than 0.05). Glucose levels were proportionately reduced in diabetic rats treated with cyclosporine. Area under the concentration-time curve, half-life and volume of distribution of cyclosporine were significantly reduced in diabetic rats compared to non-diabetic controls. In summary, the pharmacokinetics and pharmacodynamics of cyclosporine were significantly different in the insulin-dependent diabetic rat model compared to normal controls. Furthermore, short-term cyclosporine therapy reduced the extent of experimental diabetic nephropathy observed in this model.

show abstract

Effects of cyclosporine in recent-onset juvenile type 1 diabetes: Impact of age and duration of disease

Cited by 29 publications

References 6 publications

Insulin: moments in history

Insulin: moments in history

Induction and Pathophysiology of Remission of Insulin-Dependent Diabetes Mellitus during Administration of Ciclosporin

Cyclosporine pharmacokinetics and effect in the Type I diabetic rat model

Contact Info

Product

Resources

About