title: Insensitivity to cyclosporine may explain the HLA-DRw6 recipient effect.
abstract: Clinical as well as experimental studies have found an interindividual variability in the immunosuppressive effect of cyclosporine (CsA). In renal transplant patients treated with CsA and prednisolone alone, biopsy-verified rejections were significantly more frequent in DRw6-positive than in DRw6-negative graft recipients. The relative risk for developing a graft rejection independently of the CsA blood levels increased in HLA-DRw6-positive transplant patients. Although no statistical significance of the CsA levels within different DR phenotypes could be assessed, HLA-DR2-positive graft recipients with biopsy-verified rejection episodes had significantly lower CsA levels than DR2-negative patients (P = 0.01). Our results would indicate a very low CsA sensitivity of HLA-DRw6-positive graft recipients and might explain previous results describing an increased incidence of rejection and decreased graft survival rates in these patients.
authors: 2nd Department of Medicine, Institute of Immunology, University of Vienna, Vienna, Austria.
authors: S
authors: S
authors: Kudlacek
authors: G J
authors: GJ
authors: Zlabinger
authors: E
authors: E
authors: Pohanka
authors: G
authors: G
authors: Hamilton
authors: A
authors: A
authors: Rosenmayr
authors: J
authors: J
authors: Kovarik
mesh_terms: D000961:Antilymphocyte Serum / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D004351:Drug Resistance / Q000276:immunology*; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology; D015236:HLA-C Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D016853:Muromonab-CD3 / Q000627:therapeutic use
chemical_list: D000961:Antilymphocyte Serum; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D016572:Cyclosporine