Cyclosporin A increases somatomedin C insulin-like growth factor I levels in chronic rheumatic diseases.
OBJECTIVE
To determine whether anabolic hormones that affect the musculoskeletal system and active on the immune cells changed during cyclosporin A (CysA) therapy.


METHODS
We carried out a randomized study of patients with rheumatic disease attending the outpatient clinic for rheumatic diseases. Twenty-four patients with chronic arthritis [20 with rheumatoid arthritis (RA) and 4 with psoriatic arthritis (PsA)] were divided into 2 groups (10 RA, 2 PsA) and randomly given CysA 5 mg/kg daily or hydroxychloroquine (OH-Chlor) 6 mg/kg daily in divided doses.


RESULTS
A significant increase of insulin-like growth factor I (IGF-I) (somatomedin C) levels and of bone Gla protein was shown after 2 months in the CysA treated group, but not in the OH-Chlor group. A statistically significant correlation was observed between changes of IGF-I levels and of dehydroepiandrosterone sulphate (DHEAS). This finding was confirmed in a further series of 39 patients. No changes were seen in 25 OH-D, 1-25(OH)2-D3 or parathyroid hormone after CysA.


CONCLUSIONS
The effects of CysA on IGF-I may explain some of the clinical, immunologic, and metabolic results during CysA treatment of rheumatic diseases.
Ferraccioli
G
G
Department of Internal Medicine, School of Medicine, General Hospital, Udine, Italy.
Guerra
P
P
Rizzi
V
V
Bartoli
E
E
D015535:Arthritis, Psoriatic / Q000097:blood* / Q000188:drug therapy*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy*; D016572:Cyclosporine / Q000627:therapeutic use*; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood
D015675:Osteocalcin; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D007334:Insulin-Like Growth Factor I; D016572:Cyclosporine