Low-dose allopurinol plus azathioprine/ cyclosporin/prednisolone, a novel immunosuppressive regimen

The effect of allopurinol and low-dose thiopurine combination therapy on the activity of three pivotal thiopurine metabolizing enzymes: Results from a prospective pharmacological study

“…The HGPRT activity was measured in 20,000 g diluted supernatant, as described earlier. 26,27 Final substrate concentrations were 1.86 mM 5-phosporibosyl-1-pyrophosphate (PRPP) (Sigma-Aldrich Corp., St. Louis, MO, USA), with (18-28 μg protein per assay) and 0.15 mM [8][9][10][11][12][13][14] C] hypoxanthine (47 mCi/mmol, Moravek Biochemicals Inc., Brea, CA, USA).…”

“…3,9,10 The classical XO inhibitor allopurinol, usually prescribed for the treatment of gout, can enhance the efficacy of thiopurine therapy in renal transplant and IBD patients. [11][12][13][14][15][16] The enhanced efficacy is assumed to be due to an increase of 6-TGN concentrations. As severe leukopenia may occur with high 6-TGN concentrations, thiopurine dosages need to be reduced to approximately 25% of their original weight-based dose during combination therapy.…”

A retrospective study of hyperurecemia in renal transplant recipients

“…Allopurinol reduces renal vasoconstriction and decrease in GFR 17,18 reduce immune response to antigen in normal mice 26,27,28 and also slows progression of renal disease. However medications used in hyperuricemic patients have got many problems inherent to them.…”

Could Uric acid have a Pathogenic Role in Chronic Allograft Dysfunction?

“…Allopurinol has also been shown to reduce immune responses to antigens in normal mice [41]. Moreover, one clinical report suggested that the addition of allopurinol translated into less rejection in renal transplant recipients [42].…”