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肾移植前后通过淋巴细胞免疫抑制剂敏感性试验评估环孢素的药理疗效。

Cyclosporine pharmacological efficacy estimated by lymphocyte immunosuppressant sensitivity test before and after renal transplantation.

作者信息

Sugiyama K, Isogai K, Toyama A, Satoh H, Saito K, Nakagawa Y, Tasaki M, Takahashi K, Saito N, Hirano T

机构信息

Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan.

出版信息

J Clin Pharm Ther. 2009 Oct;34(5):539-45. doi: 10.1111/j.1365-2710.2009.01036.x.

Abstract

OBJECTIVE

Lymphocyte immunosuppressant sensitivity test (LIST) is useful for predicting the pharmacological efficacy of immunosuppressive agents. In this study, the pharmacological efficacy of cyclosporine was estimated by LIST before and after renal transplantation.

METHODS

Lymphocyte immunosuppressant sensitivity test was performed by the 3-(4,5-dimethylthiazol-2-yl)-2,5diphenyltetrazolium bromide (MTT) assay before and at 1, 3, and 12 months after transplantation in 19 consecutive renal transplant recipients.

RESULTS

There was wide intersubject variability in cyclosporine IC50 before transplantation [Mean (SD) of 593.9 (1067.6) ng/mL]. This variability worsened 1 month after transplantation [525.7 (1532.7) ng/mL] but decreased at 3 months (193.5 (347.9) ng/mL) and 12 months (75.4 (95.4) ng/mL). In this small study, observed differences in IC50 values for the individual subjects at various time intervals was not associated with the occurrence of rejection, graft loss, and infection episodes.

CONCLUSION

Lymphocyte sensitivity to cyclosporine assessed by the LIST assay showed a high level of inter-subject variability particularly before and 1 month after transplantation. The observed difference in IC50 values was not associated with clinical outcome in this small study.

摘要

目的

淋巴细胞免疫抑制剂敏感性试验(LIST)有助于预测免疫抑制剂的药理疗效。在本研究中,通过LIST评估肾移植前后环孢素的药理疗效。

方法

对19例连续肾移植受者在移植前及移植后1、3和12个月采用3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四氮唑溴盐(MTT)法进行淋巴细胞免疫抑制剂敏感性试验。

结果

移植前环孢素IC50存在较大的个体间差异[平均值(标准差)为593.9(1067.6)ng/mL]。这种差异在移植后1个月恶化[525.7(1532.7)ng/mL],但在3个月(193.5(347.9)ng/mL)和12个月(75.4(95.4)ng/mL)时降低。在这项小型研究中,各时间点个体受试者IC50值的观察差异与排斥反应、移植物丢失和感染事件的发生无关。

结论

通过LIST试验评估的淋巴细胞对环孢素的敏感性显示出较高的个体间差异,尤其是在移植前和移植后1个月。在这项小型研究中,观察到的IC50值差异与临床结局无关。

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