Cyclosporine: a new immunosuppressive agent for organ transplantation.
Cyclosporine, a cyclic endecapeptide of fungal origin, has recently been released for use in clinical transplantation. Trials in kidney, heart, liver and bone marrow recipients were encouraging: 1-year graft survival rates were 70% to 80% for kidney and heart recipients, and 60% to 65% for liver allograft recipients. Cyclosporine is also effective in treating bone marrow recipients with acute graft-versus-host disease. The drug selectively inhibits T-helper cell production of growth factors essential for B cell and cytotoxic T-cell differentiation and proliferation, while allowing expansion of suppressor T-cell populations. Drug absorption varies greatly, necessitating monitoring of drug level and individualization of therapy. Nephrotoxicity is the most frequent side effect of cyclosporine. An increased incidence of B-cell lymphomas seen when cyclosporine was used in conjunction with cytotoxic agents or anti-lymphocyte globulin has very rarely been observed when concomitant immunosuppression has been limited to low-dose corticosteroids. Lower initial doses of cyclosporine, followed by more rapid tapering may reduce the incidence of nephrotoxicity without compromising improved graft outcome.
D000818:Animals; D001379:Azathioprine / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D056486:Chemical and Drug Induced Liver Injury; D003524:Cyclosporins / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D006085:Graft Survival / Q000187:drug effects; D006086:Graft vs Host Disease / Q000188:drug therapy; D016027:Heart Transplantation; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016040:Lung Transplantation; D008223:Lymphoma / Q000139:chemically induced; D016035:Pancreas Transplantation; D011241:Prednisone / Q000627:therapeutic use; D014181:Transplantation Immunology
D003524:Cyclosporins; D001379:Azathioprine; D011241:Prednisone