Ciclosporin A Tapering Monitored by NFAT-Regulated Gene Expression: A New Concept of Individual Immunosuppression

摘要: Background. The impact of long-term immunosuppression in renal transplant recipients with respect to safety and efficacy remains undetermined. Pharmacodynamic monitoring the relative reduction T-cell-specific gene expression treated cyclosporine A (CsA) was applied this study. Methods. During study, 20 stable tapered CsA dose patients (matched for age, gender, dose, time after transplantation) were compared a median period 18 months (range 6-44). two stages 15% each, nuclear factor activated T cells (NFAT)-regulated genes determined by reverse-transcription polymerase chain reaction method at trough level 2 hr oral uptake. Results. initial residual intake increased from 6.31% 1.30-16.6) 21.3% 6.58-31.8) dosage reduction. In one patient, more than 40% resulted reversible Banff 1A rejection episode. Blood pressure significantly lower (P<0.05). pair-matched control group NFAT-regulated comparable before follow-up (7.45% [range 0.21-18.3] vs. 5.87% [rangeO.66-13.2]; P=NS). Estimated glomerular filtration rate worse Conclusion. Our observation suggests that measurement CsA-treated is promising tool monitor patients. An increase may result an acute