Zuckermann A, Klepetko W
Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria.
Transplant Proc. 2004 Mar;36(2 Suppl):331S-336S. doi: 10.1016/j.transproceed.2004.01.024.
The use of cyclosporine (CyA) in clinical thoracic transplantation has markedly improved the survival and quality of life of patients in the past 2 decades. In the mid-1990s a significant advance in formulation design took place with the introduction of Neoral. This new microemulsion formulation of CyA demonstrates reduced intersubject and intrasubject variability in absorption and improved oral bioavailability compared with the oil-based CyA formulation. Moreover, C2 measurements of CyA could result in an even better method to avoid overimmunosuppression. On the other hand, generic alternatives of CyA could potentially reduce costs to transplant recipients as well as to the general community. Since the initiation of tacrolimus, mycophenolate mofetil, and rapamycin, slow but expanding variations of immunosuppressive protocols have taken place. Transplantation medicine is thus becoming an increasingly exciting and innovative field, in which CyA continues to play a central role as the core immunosuppressant of choice for the majority of patients.
在过去20年里，环孢素（CyA）在临床胸科移植中的应用显著提高了患者的生存率和生活质量。20世纪90年代中期，随着新山地明（Neoral）的推出，制剂设计取得了重大进展。与油基环孢素制剂相比，这种新型环孢素微乳剂制剂在吸收方面表现出更低的个体间和个体内变异性，并提高了口服生物利用度。此外，环孢素的C2测量可能会带来一种更好的方法来避免免疫抑制过度。另一方面，环孢素的仿制药可能会降低移植受者以及普通大众的成本。自从他克莫司、霉酚酸酯和雷帕霉素开始应用以来，免疫抑制方案出现了缓慢但不断扩展的变化。因此，移植医学正成为一个越来越令人兴奋和创新的领域，在这个领域中，环孢素作为大多数患者首选的核心免疫抑制剂继续发挥着核心作用。
