Landow R K
University of Southern California School of Medicine, Los Angeles.
Dermatol Clin. 1988 Oct;6(4):575-84.
Since its isolation less than 20 years ago, cyclosporine has become one of the major drugs in the armamentarium of transplant surgeons. A serendipitous event in 1979 suggested the drug might offer significant benefits in patients with psoriasis. Multiple trials have subsequently confirmed its usefulness in psoriasis at steadily decreasing dosages. Administered orally, the drug must be taken in a ritualistic fashion as it tends to sequestrate on the sides of the glass. A routine determination of blood levels becomes important in order to maintain the peak and trough concentrations within a relatively narrow window of safety. Depending on the particular assay used, significant differences in concentrations appear, making knowledge of the laboratory's normal values essential. Blood levels of cyclosporine vary with multiple drugs, including erythromycin, prednisone, and ketoconazole. The drug acts principally via its interference with the function of the helper T lymphocytes. Clofazimine (Lamprene) offers another weapon, especially for therapy of resistant pustulosis of the palms and soles.
自不到20年前被分离出来以来，环孢素已成为移植外科医生治疗手段中的主要药物之一。1979年的一次偶然事件表明，该药物可能对银屑病患者有显著益处。随后的多项试验证实了其在银屑病治疗中的有效性，且所需剂量在稳步降低。口服该药物时，必须按常规方式服用，因为它容易附着在玻璃杯壁上。为了将血药浓度的峰值和谷值维持在相对较窄的安全范围内，常规测定血药浓度变得很重要。根据所使用的特定检测方法，浓度会出现显著差异，因此了解实验室的正常数值至关重要。环孢素的血药浓度会因多种药物而变化，包括红霉素、泼尼松和酮康唑。该药物主要通过干扰辅助性T淋巴细胞的功能发挥作用。氯法齐明（氯苯吩嗪）提供了另一种治疗手段，尤其适用于治疗掌跖部顽固性脓疱病。
