title: Nutritional immunomodulation leads to enhanced allograft survival in combination with cyclosporine A and rapamycin, but not FK506.
abstract: BACKGROUND
  Recently, specific immunonutrients were found to increase experimental allograft survival when combined with cyclosporine A (CsA). This study compared the effect on rat cardiac allograft survival when nutritional immunomodulation was used with CsA, rapamycin (Rapa), or tacrolimus (FK506).
  
  
  METHODS
  Intra-abdominal ACI to Lewis cardiac allografts were performed and assessed daily by palpation. Study groups included untreated controls and those receiving CsA, Rapa, or FK506. Rats were fed ad libitum with Impact diet (fortified with fish oil, arginine, and RNA) or standard rat food. Further study groups were transplanted that received a donor-specific transfusion in addition to immunosuppression and diet.
  
  
  RESULTS
  Allograft survival was extended by combining Impact with CsA (45.3+/-19 days) and Rapa (165.3+/-52 days), but not FK506 (12.4+/-3.2 days). Mean graft survival in the Rapa/Impact group met criteria for functional tolerance. The addition of a donor-specific transfusion did not lead to graft survival advantages over similar groups not receiving a donor-specific transfusion.
  
  
  CONCLUSIONS
  The use of immunonutrients improves transplant outcome in animals treated with short courses of CsA and Rapa, but not FK506. These findings highlight the potential differences in the effects of nutritional immunomodulation with different immunosuppressive drugs in the treatment of transplant patients.
authors.affiliation: Department of Surgery, College of Medicine, University of Cincinnati, OH 45267-0558, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Gibson
authors.forename: J F
authors.initials: JF
authors.lastname: Valente
authors.forename: J W
authors.initials: JW
authors.lastname: Alexander
authors.forename: D A
authors.initials: DA
authors.lastname: Custer
authors.forename: B G
authors.initials: BG
authors.lastname: Li
authors.forename: S
authors.initials: S
authors.lastname: Frede
authors.forename: G F
authors.initials: GF
authors.lastname: Babcock
authors.forename: C K
authors.initials: CK
authors.lastname: Ogle
mesh_terms: D000818:Animals; D001120:Arginine; D016572:Cyclosporine / Q000627:therapeutic use*; D004032:Diet; D019587:Dietary Supplements; D005395:Fish Oils; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology / Q000502:physiology*; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D012313:RNA; D051381:Rats; D011912:Rats, Inbred ACI; D011917:Rats, Inbred Lew; D020123:Sirolimus / Q000627:therapeutic use*; D016559:Tacrolimus / Q000627:therapeutic use; D014184:Transplantation, Homologous
chemical_list: D005395:Fish Oils; D007166:Immunosuppressive Agents; D012313:RNA; D016572:Cyclosporine; D001120:Arginine; D020123:Sirolimus; D016559:Tacrolimus