title: Cytokines and cell surface receptors as target end points of immunosuppression with cyclosporine A.
abstract: Targets of cyclosporine (CsA) were identified from an array of stimulated lymphocyte responses (sLR) comprising 34 stimulation conditions in whole blood from 3 normal human volunteers (NHV) containing clinically relevant CsA concentrations (0-1200 ng/ml) in vitro. In whole blood from 5 additional NHV, selected targets (intracellular interleukin-2 [IL-2], tumor-necrosis factor-alpha [TNF-alpha], and interferon-gamma [IFN-gamma]) were measured in phorbol myristate acetate (PMA)-ionomycin-stimulated T lymphocytes. Effect:concentration relationships were analyzed with E(max) pharmacodynamic (PD) equations and expressed as the concentration associated with one-half maximal inhibitory effect (EC(50)). CsA demonstrated a rich matrix of inhibitory effects on T cells (CD3(+)), B cells (CD19(+)), dendritic cells (DC) (CD11c(+)), and basophils (CD123(+)) but not on monocytes (CD14(+)) (n = 3). PD analyses suggested that the EC(50) of CsA (1) for IL-2 in CD3(+) cells in NHV (n = 8) was similar to the EC(50) demonstrated by us previously in CD4(+) cells from transplanted patients (n = 13) (EC(50) = 260 ng/ml vs. 249 ng/ml), (2) for each cytokine was different under identical stimulation conditions (TNF-alpha, 324 ng/ml; IFN-gamma, 504 ng/ml), and (3) was relatively constant for a given cytokine under different stimulation conditions (e.g., PMA-ionomycin or the staphylococcal enterotoxin B [SEB] superantigen). In conclusion, inhibition of cytokine targets by CsA is concentration dependent. Further, a given CsA concentration may produce similar inhibitory effects across different stimulation conditions. Measurement of cytokine target expression may, therefore, allow effect-controlled administration of CsA during clinical transplantation.
authors.affiliation: Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA. sindhir@chplink.chp.edu
authors.forename: R
authors.initials: R
authors.lastname: Sindhi
authors.forename: J
authors.initials: J
authors.lastname: Allaert
authors.forename: D
authors.initials: D
authors.lastname: Gladding
authors.forename: B
authors.initials: B
authors.lastname: Koppelman
authors.forename: J F
authors.initials: JF
authors.lastname: Dunne
mesh_terms: D000328:Adult; D000944:Antigens, Differentiation, B-Lymphocyte / Q000032:analysis*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D001491:Basophils / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D016572:Cyclosporine / Q000494:pharmacology*; D016207:Cytokines / Q000032:analysis*; D003713:Dendritic Cells / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D008213:Lymphocyte Activation / Q000187:drug effects; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism
chemical_list: D000944:Antigens, Differentiation, B-Lymphocyte; D015415:Biomarkers; D016207:Cytokines; D007166:Immunosuppressive Agents; D016572:Cyclosporine