Inhibition of Insulin Release by Cyclosporine and Production of Peripheral Insulin Resistance in the Dog

He, Wahlstrom; Lavelle-Jones, Michael; Endres, Donald R.; Akimoto, Ryuji; Kolterman, Orville G.; Ar, Moossa

doi:10.1097/00007890-199003000-00023

Cited by 29 publications

(19 citation statements)

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“…Diabetic nephropathy by itself is one of the prime causes of end stage renal disease (ESRD). Furthermore, cyclosporine when used in conjunction can impair glucose metabolism by reducing insulin secretion and promoting resistance in the tissues to the peripheral effects of insulin [21]. Hence, cyclosporine use in diabetic patients, along with steroids which are used most often in this setting, has a synergistic effect on kidney injury especially within the first 100 days after HSCT [8].…”

Section: Incidence Of Akimentioning

confidence: 99%

“…This indicates a time lag in the development of renal failure [14]. CsA can impair glucose metabolism and its use in diabetics may have a synergistic effect on kidney injury due to diabetes related nephropathy [8, 21]. Some studies in heart transplant recipients have demonstrated that replacing CsA by inhibitor of mammalian target of rapamycin such as sirolimus improves renal recovery; however further research is essential to assess its impact [41].…”

Section: Pathophysiology Of Acute Kidney Injury In Hsctmentioning

confidence: 99%

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Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Krishnappa

Gupta

Manu

et al. 2016

International Journal of Nephrology

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Hematopoietic stem cell transplantation (HSCT) is a highly effective treatment strategy for lymphoproliferative disorders and bone marrow failure states including aplastic anemia and thalassemia. However, its use has been limited by the increased treatment related complications, including acute kidney injury (AKI) with an incidence ranging from 20% to 73%. AKI after HSCT has been associated with an increased risk of mortality. The incidence of AKI reported in recipients of myeloablative allogeneic transplant is considerably higher in comparison to other subclasses mainly due to use of cyclosporine and development of graft-versus-host disease (GVHD) in allogeneic groups. Acute GVHD is by itself a major independent risk factor for the development of AKI in HSCT recipients. The other major risk factors are sepsis, nephrotoxic medications (amphotericin B, acyclovir, aminoglycosides, and cyclosporine), hepatic sinusoidal obstruction syndrome (SOS), thrombotic microangiopathy (TMA), marrow infusion toxicity, and tumor lysis syndrome. The mainstay of management of AKI in these patients is avoidance of risk factors contributing to AKI, including use of reduced intensity-conditioning regimen, close monitoring of nephrotoxic medications, and use of alternative antifungals for prophylaxis against infection. Also, early identification and effective management of sepsis, tumor lysis syndrome, marrow infusion toxicity, and hepatic SOS help in reducing the incidence of AKI in HSCT recipients.

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Section: Incidence Of Akimentioning

confidence: 99%

Section: Pathophysiology Of Acute Kidney Injury In Hsctmentioning

confidence: 99%

Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Krishnappa

Gupta

Manu

et al. 2016

International Journal of Nephrology

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“…Probably, an altered insulin sensitivity is the cause of these derangements [5]. Although the same effect has been shown to be due to CyA medication [15], the impact of steroid treatment after renal transplantation is probably quantitatively more important [4].…”

Section: Discussionmentioning

confidence: 99%

Cyclosporin A has no impact on alterations of the lipid profile after renal transplantation

Rosman¹,

Evéquoz²,

Landmann³

et al. 1992

Transplant International

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The literature contains conflicting ideas regarding the role of cyclosporin A (CyA) in the induction of posttransplant dyslipidemia. The available studies contain small numbers of patients, especially on Cy A monotherapy. We compared 65 patients on conventional azathioprine-prednisone therapy (AP) with 85 patients on CyA monotherapy, 19 on CyA-azathioprine therapy (CA), 20 on CyA-prednisone therapy (CP), and 52 on a triple therapy with CyA, azathioprine, and prednisone (CAP). From the results, it is concluded that patients on CyA monotherapy had lower serum cholesterol levels, with a lower high-density lipoprotein (HDL)-cholesterol level, probably due to the lower total cholesterol, compared with AP patients. From all groups, the CyA monotherapy group showed the most beneficial lipid profile. No additive negative influences of CyA when combined with other immunosuppressive drugs were noted. Thus, a correlation between derangements of the lipid profile and Cy A therapy could not be confirmed. Further analysis of our data showed negative influences of antihypertensive treatment on lipid metabolism, particularly in the case of treatment with ,8-blockers or diuretics. It cannot be excluded that studies showing a negative influence of CyA therapy on lipid homeostasis were biased by secondary factors like antihypertensive therapy, which was often not taken into account.

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“…Chronic use of CsA is known to have side effects most common of them being nephrotoxicity and hyperglycaemia . CsA also causes abnormal glucose homeostasis by decreasing pancreatic insulin release and increasing peripheral insulin resistance resulting in development of hyperglycaemia …”

Section: Introductionmentioning

confidence: 99%

“…[2] CsA also causes abnormal glucose homeostasis by decreasing pancreatic insulin release and increasing peripheral insulin resistance resulting in development of hyperglycaemia. [5,6] Thymoquinone (2-Isoprop l-5-methylbenzo-1,4-quinone) (TQ), is the bioactive component of volatile oil of black seed, Nigella sativa. Many researches demonstrated that TQ has nephroprotective, anti-hyperglycemic, hypolpidmic, anti-inflammatory, anti-neoplastic and hepatorotective activity.…”

Section: Introductionmentioning

confidence: 99%