Calne R
Department of Surgery, Douglas House Annexe, Cambridge, UK.
Transplant Proc. 2004 Mar;36(2 Suppl):13S-15S. doi: 10.1016/j.transproceed.2004.01.042.
In this short review I show how cyclosporine fits into the broader picture of immunosuppression for organ allografting. Before cyclosporine there were some good results, particularly in kidney grafting, but also a failure rate of 50% of grafts by 1 year. Cyclosporine changed the graft survival of 1 year to 80%, although at 10 years the graft survival was little different from patients treated with azathioprine and steroids. Nevertheless, many patients achieved good function in their kidneys when treated with cyclosporine; these patients would have lost the kidneys under the old regimen. The cause of the late failure in patients treated with cyclosporine was predominantly nephrotoxicity due to the calcineurine inhibition, damaging the kidneys. Now that this is better understood and new drugs are available, many regimens have been tried but cyclosporine remains an important tool for the clinician in the treatment of patients with organ allografts.
在这篇简短的综述中，我将展示环孢素如何融入器官移植免疫抑制的更广泛图景。在环孢素出现之前，已经取得了一些良好的结果，尤其是在肾移植方面，但到1年时仍有50%的移植肾失败率。环孢素将1年移植肾存活率提高到了80%，尽管在10年时，移植肾存活率与接受硫唑嘌呤和类固醇治疗的患者相比差异不大。然而，许多接受环孢素治疗的患者肾脏功能良好；在旧方案下，这些患者的肾脏将会丧失。接受环孢素治疗的患者晚期失败的主要原因是由于钙调神经磷酸酶抑制导致的肾毒性，损害了肾脏。鉴于对此有了更好的理解且有了新药，人们尝试了许多方案，但环孢素仍然是临床医生治疗器官移植患者的重要工具。
