El-Agroudy Amgad E, Ismail Amani M, Nassar Mohamed, Ghoneim Mohamed A
Urology & Nephrology Center, Mansoura University, Mansoura, Egypt.
Exp Clin Transplant. 2008 Dec;6(4):282-6.
We sought to assess whether the single cyclosporine concentration taken 2 hours after administration (C2) is a good parameter to predict a drug's maximal concentration (Cmax) value in Egyptian kidney transplant recipients.
Fifty stable Egyptian kidney transplant recipients with a previously diagnosed schistosomal infection were compared with 50 Egyptian kidney transplant recipients without a schistosomal infection regarding cyclosporine concentrations at time 0 (trough), and then at 1.5, 2, 2.5, 3, and 3.5 hours after a dose of cyclosporine. We used a linear regression analysis to assess any statistically significant differences between the different cyclosporine time concentrations and drug dosages.
Patients in the schistosomal group had significantly lower C2 levels (511 -/+ 118 nmol/L) compared with those in the nonschistosomal (control) group (669 -/+ 213 nmol/L) (P < .05), whereas the C2.5 level was significantly higher (730 -/+ 215 and 527 -/+ 129 nmol/L, respectively; P < .05). A significant linear regression relation was determined for only C2.5 in the schistosomal group with both morning cyclosporine dose and cyclosporine dose expressed as mg/kg/d (P = .0123, r = .573018).
Egyptian patients have special characteristics with regard to drug absorption and metabolism, mostly owing to schistosomal infection, and they may need the use of C2.5 to monitor cyclosporine. If confirmed by subsequent, larger studies, our findings may have a significant effect on our understanding and management of cyclosporine immunosuppression in clinical renal transplants with persons of different ethnicities.
我们试图评估给药2小时后的单一环孢素浓度（C2）是否是预测埃及肾移植受者药物最大浓度（Cmax）值的良好参数。
将50例先前诊断为血吸虫感染的稳定埃及肾移植受者与50例无血吸虫感染的埃及肾移植受者在时间0（谷值）以及给予一剂环孢素后1.5、2、2.5、3和3.5小时的环孢素浓度进行比较。我们使用线性回归分析来评估不同环孢素时间浓度与药物剂量之间的任何统计学显著差异。
血吸虫组患者的C2水平（511±118 nmol/L）显著低于非血吸虫（对照）组（669±213 nmol/L）（P<.05），而C2.5水平显著更高（分别为730±215和527±129 nmol/L；P<.05）。仅在血吸虫组中确定了C2.5与早晨环孢素剂量以及以mg/kg/d表示的环孢素剂量之间存在显著的线性回归关系（P = .0123，r = .573018）。
埃及患者在药物吸收和代谢方面具有特殊特征，主要是由于血吸虫感染，他们可能需要使用C2.5来监测环孢素。如果后续更大规模的研究证实，我们的发现可能会对我们理解和管理不同种族人群临床肾移植中环孢素免疫抑制产生重大影响。
