[Study of the efficacy of cyclosporine used in patients at high risk of keratograft rejection. Communication 2. Immunological treatment monitoring].
The paper presents the results of a long-term (up to 2-year) clinical and immunological monitoring of 25 patients operated on for leukomas of various etiology, who were a high risk group. The objective of the study was to clarify the causes of the inefficiency of treatment with cyclosporine (Cs) and to develop specific indications for its usage. The autoimmune reactions against the cornea (a cellular response) were studied. The levels of cytokines (interferon (IFN)-gamma, IFN-alpha, interleukin (IL)-1beta, IL-2, IL-4, IL-8, and IL-10) and the markers of herpesvirus activation (IgM antibodies) were defined. Retrospectively, the patients were divided into groups according to the pattern of a postoperative period and to the type of immunograms: moderately reactive (n = 6 (24%)), hyperreactive (n = 6 (24%)), and areactive (n = 13 (52%)). The findings suggest that the inefficiency of treatment using the Cs dosage regimens may be due to the wide variability and specific features of immunological responsiveness in particularly critically ill patients. In the authors' opinion, areactive patients (most of them were the post-burnt) need the most careful approach. Overall, the findings suggest that it is necessary to strictly select a Cs dosage regimen on an individual basis and to correct it during clinical and immunological monitoring.
Slepova
O S
OS
Bykovskaia
G N
GN
Makarov
P V
PV
Balaian
T G
TG
Oganesian
O G
OG
Iluridze
S L
SL
D003315:Cornea / Q000276:immunology* / Q000473:pathology; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D016572:Cyclosporine / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects* / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015948:Keratoplasty, Penetrating; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome