Shibata N, Hoshino N, Minouchi T, Yamaji A
Department of Hospital Pharmacy, Shiga University of Medical Science, Otsu, Japan.
Eur J Clin Pharmacol. 1997;51(6):455-9. doi: 10.1007/s002280050230.
The aim of this study was to examine the relationship between erythrocyte-to-plasma distribution ratio of cyclosporin (CsA-EP) and lymphocyte proliferation as an indicator of immunosuppressive activity in renal transplant patients.
A total of 113 whole blood samples obtained from 6 inpatients with renal transplantation were analysed. CsA concentrations in blood and plasma at trough were measured by fluorescence polarization immunoassay using monoclonal antibody, lymphocyte proliferation in response to phytohaemagglutinin was evaluated by the fluorimetric derivatization method using ethidium bromide and the stimulation index (SI) was calculated.
There was no correlation between CsA dose and trough levels (vs blood CsA, r2 = 0.052; vs plasma CsA, r2 = 0.054, n = 113). A significant negative correlation between the SI and the CsA-EP was found in individual or all samples (r2 = 0.224, p < 0.0001, n = 113), whereas CsA trough levels in blood or plasma had no correlation with the SI.
Although the degree of contribution of CsA-EP to the SI was 22%, the CsA-EP is a more useful predictor of changes in immunosuppressive response than CsA concentration in blood or plasma. The adoption of the CsA-EP as a monitoring index could be helpful in assessing the appropriateness of CsA immunosuppressive therapy.
本研究旨在探讨肾移植患者中环孢素红细胞与血浆分布比（CsA-EP）与作为免疫抑制活性指标的淋巴细胞增殖之间的关系。
分析了从6例肾移植住院患者获得的总共113份全血样本。使用单克隆抗体通过荧光偏振免疫测定法测量谷值时血液和血浆中的环孢素浓度，使用溴化乙锭通过荧光衍生化法评估对植物血凝素反应的淋巴细胞增殖，并计算刺激指数（SI）。
环孢素剂量与谷值水平之间无相关性（与血液中环孢素相比，r2 = 0.052；与血浆中环孢素相比，r2 = 0.054，n = 113）。在个体或所有样本中发现刺激指数与CsA-EP之间存在显著负相关（r2 = 0.224，p < 0.0001，n = 113），而血液或血浆中的环孢素谷值水平与刺激指数无相关性。
尽管CsA-EP对刺激指数的贡献程度为22%，但与血液或血浆中环孢素浓度相比，CsA-EP是免疫抑制反应变化的更有用预测指标。采用CsA-EP作为监测指标可能有助于评估环孢素免疫抑制治疗的适宜性。
