title: Enhancement of immunosuppression by substitution of fish oil for olive oil as a vehicle for cyclosporine.
abstract: As previously reported, acute cyclosporine-induced nephrotoxicity is characterized by a decline in glomerular filtration rate and a selective intrarenal production of the vasoconstrictor thromboxane (TxA2), but not vasodilator prostaglandin E2 (PGE2), or prostacyclin (PGI2), cyclooxygenase metabolites. Fish oils (FO), that are rich in n-3 polyunsaturated fatty acids have a high affinity for cyclooxygenase but serve as poor substrate inhibit TxA2 synthesis. We have shown that when FO replaces olive oil (OO) as the vehicle for CsA, CsA-induced nephrotoxicity and increased TxA2 synthesis are obviated in rodent models. In this study, we demonstrate that the FO vehicle for CsA does not compromise CsA's immunosuppressive properties as deduced from studies of a delayed-type hypersensitivity (DTH) model in BALB/c mice and in a rat heart transplant model. In fact, concurrent FO administration with CsA actually enhances immunosuppression. A dose of CsA incapable of blunting DTH when injected in OO was suppressive when given in FO. Administration of as little as 0.05 ml of FO vehicle potentiated the suppressive action of CsA. In addition, nonconcurrent dietary supplementation of FO in animals receiving CsA caused an increase in the immunosuppressive action of CsA in DTH. FO alone reduced DTH as compared with OO, but was far less effective than CsA plus FO. Furthermore, doses of CsA (5 mg/kg/day or 1.5 mg/kg/day), which are subtherapeutic when administered with OO, prolonged engraftment of Lewis recipients of Lewis x Brown-Norway F1 hearts when CsA was solubilized with FO. These studies indicate that concurrent administration of CsA and FO potentiates the activity of CsA and thus increases its therapeutic index. Thus, CsA plus FO is potentially a safe, potent antirejection therapy worthy of clinical testing, especially insofar as FO prevents CsA-induced acute nephrotoxicity in the rodent.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
authors.forename: V E
authors.initials: VE
authors.lastname: Kelley
authors.forename: R L
authors.initials: RL
authors.lastname: Kirkman
authors.forename: M
authors.initials: M
authors.lastname: Bastos
authors.forename: L V
authors.initials: LV
authors.lastname: Barrett
authors.forename: T B
authors.initials: TB
authors.lastname: Strom
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000818:Animals; D003524:Cyclosporins / Q000008:administration & dosage*; D005395:Fish Oils / Q000008:administration & dosage*; D016027:Heart Transplantation; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D000069463:Olive Oil; D014677:Pharmaceutical Vehicles; D010938:Plant Oils / Q000008:administration & dosage*; D051381:Rats; D011917:Rats, Inbred Lew; D011920:Rats, Inbred WF; D012995:Solubility
chemical_list: D000276:Adjuvants, Immunologic; D003524:Cyclosporins; D005395:Fish Oils; D007166:Immunosuppressive Agents; D000069463:Olive Oil; D014677:Pharmaceutical Vehicles; D010938:Plant Oils