Lymphocyte drug sensitivity is useful for prediction of the antiproteinuric effect and relapse rate in cyclosporine treatment for frequent-relapse minimal change nephrotic syndrome.
OBJECTIVE
The therapeutic effect of cyclosporine A (CsA) in combination with steroids varies greatly for frequent-relapse minimal change nephrotic syndrome (FRMCNS). The association between the sensitivity of peripheral blood lymphocytes (PBLs) to CsA in vitro and the therapeutic effect of CsA in FRMCNS were investigated.


METHODS
The sensitivity of PBLs in vitro and the therapeutic effect of CsA in 23 FRMCNS patients were compared. The length of time to complete remission (CR) and the number of relapses were compared using the 50% inhibitory concentration (IC(50)) of CsA in the presence of a T-cell mitogen.


RESULTS
FRMCNS patients were divided into 2 groups: a low sensitivity group with an IC(50) of >14.8 ng/ml (GII, n = 10), and a high sensitivity group with an IC(50) of <14.8 ng/ml (GI, n = 13). Comparison of the length of time to CR between the 2 groups showed that GI reached CR earlier than GII (p < 0.01). GI had significantly fewer relapses than GII when CsA was administered for 12 months or longer (p < 0.01).


CONCLUSIONS
Lymphocyte sensitivity to CsA has the potential to be an important clinical indicator of the antiproteinuric effect and relapse rate in FRMCNS.
Yoshida
Masaharu
M
Renal Unit, Department of Internal Medicine, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan. myoshida@tokyo-med.ac.jp
Yoshikawa
Noriko
N
Akashi
Masakazu
M
Nakabayashi
Iwao
I
Watanabe
Taeko
T
Iwahori
Toru
T
Hirano
Toshihiko
T
Oka
Kitaro
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002455:Cell Division / Q000187:drug effects / Q000276:immunology; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D020128:Inhibitory Concentration 50; D008214:Lymphocytes / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy* / Q000276:immunology; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D012074:Remission Induction; D012680:Sensitivity and Specificity
D007166:Immunosuppressive Agents; D016572:Cyclosporine