title: Allergic sensitization in kidney-transplanted patients prevails under tacrolimus treatment.
abstract: BACKGROUND
  Type I allergies have repeatedly been reported after solid organ transplantation despite T cell-targeted immunosuppressive therapy. A causal relationship with tacrolimus has been proposed.
  
  
  OBJECTIVE
  The present study directly compared the occurrence of allergic sensitization and disease under tacrolimus- vs. cyclosporin A-based immunosuppressive therapy.
  
  
  METHODS
  The prevalences of IgE-mediated sensitization and allergy were assessed in a cross-sectional study of kidney-transplanted adults receiving tacrolimus (n = 100) or cyclosporin A (n = 100).
  
  
  METHODS
  included a standardized questionnaire, skin prick test and measurement of total and specific IgE against common nutritive and inhalant allergens. Results The prevalence of sensitization was significantly higher in the tacrolimus- than in the cyclosporin A-treated group (34%, n = 34, vs. 20%, n = 20; P = 0.026). The rate of clinically relevant allergy in patients receiving tacrolimus was twice that in patients receiving cyclosporin A (15%, n = 15, vs. 8%, n = 8; P = 0.12). No other factor (age, serum drug level, concomitant immunosuppressive medication, time since transplantation, underlying disease) was found to have an influence on sensitization or allergy prevalence (logistic regression).
  
  
  CONCLUSIONS
  Our results suggest that post-transplant immunosuppression with tacrolimus is associated with an increased occurrence of IgE-mediated sensitization and probably manifestation of allergic disease, which has to be treated specifically despite immunosuppressive therapy.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Gruber
authors.forename: K
authors.initials: K
authors.lastname: Tiringer
authors.forename: E
authors.initials: E
authors.lastname: Dehlink
authors.forename: T
authors.initials: T
authors.lastname: Eiwegger
authors.forename: E
authors.initials: E
authors.lastname: Mayer
authors.forename: H
authors.initials: H
authors.lastname: Konstantin
authors.forename: Z
authors.initials: Z
authors.lastname: Kikic
authors.forename: A
authors.initials: A
authors.lastname: Graf
authors.forename: Z
authors.initials: Z
authors.lastname: Szépfalusi
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004802:Eosinophilia / Q000097:blood / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012680:Sensitivity and Specificity; D012882:Skin Tests; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D007073:Immunoglobulin E; D016572:Cyclosporine; D016559:Tacrolimus