title: Strong additive effect of 1,25-dihydroxycholecalciferol and cyclosporine A but not tacrolimus in rat lung allotransplantation.
abstract: OBJECTIVE
  1,25-Dihydroxycholecalciferol (calcitriol, vitamin D3) has immunosuppressive properties. This study evaluates the effect of calcitriol in combination with either cyclosporine A or tacrolimus on acute lung allograft rejection in a rat model of unilateral left lung allotransplantation.
  
  
  METHODS
  Unilateral left lung transplantation was performed in male rats (Brown-Norway to Fischer F344, 200-250 g body weight). For immunosuppression, the following subtherapeutic doses were used: calcitriol 0.5 microg/kg/day, cyclosporine A 2.5 mg/kg/day i.p., and tacrolimus 40 microg/kg i.m. Five groups (n = 5) were analyzed: cyclosporine A; cyclosporine A and calcitriol; calcitriol; tacrolimus and calcitriol; and tacrolimus. The injections were performed for 5 days starting from the day of transplantation. Recipients were sacrificed on day 5 post-transplant. The contralateral right main bronchus and pulmonary artery were occluded for 5 min and blood was drawn for blood gas analysis. The grafts were excised, fixed in formaline and embedded in paraffin. Histological evaluation was done in blinded fashion (ISHLT 1999/rank scale). The mean and standard error of the mean (PaO2) or the median and range (rejection grading) are given. ANOVA followed by planned comparison for the PaO2 and Kruskal-Wallis ANOVA for rejection grading were applied, p < 0.05 considered significant.
  
  
  RESULTS
  Arterial PaO2 on day 5 was very low in animals treated with subtherapeutic dosages of either cyclosporine A (48 +/- 10 mmHg), calcitriol (51 +/- 3) or tacrolimus (86 +/- 22). Combined treatment with cyclosporine A and calcitriol revealed a significant improvement (248 +/- 78; p < 0.05 vs. other groups), whereas the combination of tacrolimus with calcitriol did not reveal any benefit (65 +/- 9). Rejection grading with these subtherapeutic doses did not show any significant difference between groups.
  
  
  CONCLUSIONS
  Our data indicate that cyclosporine A, but not tacrolimus, has a strong additive effect with calcitriol on acute rat lung allograft rejection.
authors.affiliation: Division of General Thoracic Surgery, University Hospital Berne, CH-3010, Berne, Switzerland.
authors.forename: Uz
authors.initials: U
authors.lastname: Stammberger
authors.forename: Bartosz
authors.initials: B
authors.lastname: Kubisa
authors.forename: Matthias
authors.initials: M
authors.lastname: Gugger
authors.forename: Erick
authors.initials: E
authors.lastname: Ayuni
authors.forename: Redaelli
authors.initials: R
authors.lastname: Claudio
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzki
authors.forename: Ralph Alexander
authors.initials: RA
authors.lastname: Schmid
mesh_terms: D000818:Animals; D002117:Calcitriol / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D004357:Drug Synergism; D006084:Graft Rejection / Q000517:prevention & control*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation; D023421:Models, Animal; D051381:Rats; D011914:Rats, Inbred BN; D011916:Rats, Inbred F344; D016559:Tacrolimus / Q000627:therapeutic use*; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D002117:Calcitriol; D016559:Tacrolimus