von Willebrand E, Häyry P
Lancet. 1983 Jul 23;2(8343):189-92. doi: 10.1016/s0140-6736(83)90173-3.
Deposits of cyclosporin A (CyA), demonstrable by fine-needle aspiration biopsy and indirect immunofluorescence, are invariably seen in the transplant parenchymal cells in cases of CyA nephrotoxicity. Deposition of CyA is accompanied by concomitant changes in parenchymal-cell morphology but not by any significant inflammation. The degree of clinical nephrotoxicity is directly correlated with the amount of CyA in the graft but has no correlation with the dose of the drug and only a marginal correlation with the concentration of CyA in the recipient plasma. After reduction of dose, the deposits rapidly disappear from the transplant, with concomitant improvement of transplant function. It is concluded that demonstration of CyA in cytological specimens of a renal transplant is at present the best method of assessing CyA nephrotoxicity and of distinguishing nephrotoxicity from rejection.
通过细针穿刺活检和间接免疫荧光法可证实，在环孢素A（CyA）肾毒性病例的移植实质细胞中总是能见到CyA沉积物。CyA的沉积伴随着实质细胞形态的相应改变，但无明显炎症。临床肾毒性程度与移植物中CyA的量直接相关，与药物剂量无关，与受体血浆中CyA的浓度仅有微弱关联。减少剂量后，沉积物迅速从移植物中消失，同时移植功能得到改善。结论是，目前在肾移植细胞学标本中检测CyA是评估CyA肾毒性以及区分肾毒性与排斥反应的最佳方法。
