title: Lymphocyte drug sensitivity is useful for prediction of the antiproteinuric effect and relapse rate in cyclosporine treatment for frequent-relapse minimal change nephrotic syndrome.
abstract: 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.
authors.affiliation: Renal Unit, Department of Internal Medicine, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan. myoshida@tokyo-med.ac.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Akashi
authors.forename: Iwao
authors.initials: I
authors.lastname: Nakabayashi
authors.forename: Taeko
authors.initials: T
authors.lastname: Watanabe
authors.forename: Toru
authors.initials: T
authors.lastname: Iwahori
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Hirano
authors.forename: Kitaro
authors.initials: K
authors.lastname: Oka
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine