Milane Aline, Abou-Abbas Linda, Osmani Lara, Saber Naja, Mefleh Nadine, Barbari Antoine
School of Pharmacy, Lebanese American University, Byblos, Lebanon.
Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Dose Response. 2021 Oct 15;19(4):15593258211042169. doi: 10.1177/15593258211042169. eCollection 2021 Oct-Dec.
This study aims to investigate a potential association between whole blood and lymphocyte Cyclosporin A (CyA) levels and the occurrence and frequency of infectious complications in kidney transplant patients.
The study involves 130 kidney transplant recipients who received CyA in addition to Mycophenolate Mofetil and steroids. CyA whole blood trough and maximum level (CyA BL and CyA BLm) as well as the corresponding levels in the lymphocytes (CyA L and CyA Lm) were measured for 6 months post-transplantation.
Cytomegalovirus (CMV) as well as urinary tract infections (UTIs) were the most commonly diagnosed with an incidence of 24.6% and 26.2%, respectively. Only CyA L showed a significant association with CMV infection occurrence (adjusted OR = 1.051, 95% CI .997-1.025, -value 0.046). A positive linear correlation was found between CyA BL, CyA BLm and CyA Lm and the number of CMV episodes per patient.
We showed an association between the CMV infections occurrence and the trough lymphocyte level of CyA (CyA L). Both lymphocyte CyA levels also correlated with the frequency of CMV infections. Further studies are needed to establish the optimal range of both CyA blood and lymphocyte levels and decrease the risk of opportunistic infections in high risk patients.
本研究旨在调查肾移植患者全血和淋巴细胞中环孢素A（CyA）水平与感染并发症的发生及频率之间的潜在关联。
该研究纳入了130名肾移植受者，这些患者除接受霉酚酸酯和类固醇治疗外还接受了CyA治疗。在移植后6个月测量CyA全血谷浓度和最高水平（CyA BL和CyA BLm）以及淋巴细胞中的相应水平（CyA L和CyA Lm）。
巨细胞病毒（CMV）感染和尿路感染（UTIs）是最常见的诊断感染，发病率分别为24.6%和26.2%。仅CyA L与CMV感染的发生存在显著关联（校正比值比=1.051，95%置信区间0.997 - 1.025，P值0.046）。发现CyA BL、CyA BLm和CyA Lm与每位患者的CMV发作次数呈正线性相关。
我们发现CMV感染的发生与CyA的淋巴细胞谷浓度（CyA L）之间存在关联。淋巴细胞CyA水平也与CMV感染的频率相关。需要进一步研究以确定CyA血液和淋巴细胞水平的最佳范围，并降低高危患者机会性感染的风险。
