Relationship between pharmacokinetics and pharmacodynamics of calcineurin inhibitors in renal transplant patients

被引：21

作者：

Albring, Antje ^{[1
]}

Wendt, Laura ^{[1
]}

Harz, Nino ^{[1
]}

Engler, Harald ^{[1
]}

Wilde, Benjamin ^{[2
]}

Kribben, Andreas ^{[2
]}

Lindemann, Monika ^{[3
]}

Schedlowski, Manfred ^{[1
]}

Witzke, Oliver ^{[2
]}

机构：

[1] Univ Hosp Essen, Inst Med Psychol & Behav Immunobiol, Essen, Germany

[2] Univ Duisburg Essen, Univ Hosp Essen, Dept Nephrol, D-45122 Essen, Germany

[3] Univ Hosp Essen, Inst Transfus Med, Essen, Germany

来源：

CLINICAL TRANSPLANTATION | 2015年 / 29卷 / 04期

关键词：

calcineurin inhibitors; cyclosporine A; pharmacodynamic; pharmacokinetic; renal transplantation; tacrolimus; ORGAN-TRANSPLANTATION; ALLOGRAFT RECIPIENTS; PHOSPHATASE-ACTIVITY; BLOOD; FOCUS;

D O I：

10.1111/ctr.12504

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

The calcineurin inhibitors (CNIs) cyclosporine A (CsA) and tacrolimus (Tac) are immunosuppressive drugs, which are typically employed in the field of organ transplantation. Both drugs have narrow therapeutic indices, highly variable pharmacokinetics, and are associated with severe adverse effects. In current clinical routine, the dose finding of CNIs is based on the measurement of their blood concentrations. However, this method is limited in its ability to determine the biological impact of the drug. Alternative monitoring strategies, focusing on the pharmacodynamics of CNIs, could help to personalize drug dosing and optimize the treatment with CNIs. Therefore, we analyzed the relationship between pharmacokinetic and pharmacodynamic of the CNIs CsA (n=9) and Tac (n=8) in stable renal transplant patients during a 12-h dosing period. We observed a significant decrease in the drug-blood concentration during the course of the day and in parallel a significant recovery of T cell function. In addition, our data document that analysis of intracellular interleukin (IL)-2 production and determination of the IL-2 release are accurate parameters for monitoring the pharmacodynamics of CNIs.

引用

页码：294 / 300

页数：7

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