Correlation between oxidative stress and immunosuppressive therapy in renal transplant recipients with an uneventful postoperative course stable renal function

Introduction: Reactive oxygen species (ROS) are important mediators of cellular damage and lipid peroxidation is the most important expression of ROS-induced oxidative stress. Recent studies have suggested that increased plasma malondialdehyde (MDA) levels are a consequence of immunosuppressive therapy. This study aims at investigating the relation between oxidative stress, renal transplantation and the immunosuppressive therapy in patients with an uneventful postoperative course. Patients-Methods: The study group comprised 39 renal patients. Three groups of renal transplant receptors with a different combination of immunosuppressive agents (Cyclosporine A, Tacrolimus, Sirolimus, Mycophenolate mofetil, Daclizumab, Basiliximab and Steroids) were studied. All patients had an uneventful postoperative course. Plasma malondialdehyde (MDA) levels were measured before transplantation and one and six months after. Plasma concentration of endogenous creatinine (Cr) was used as the measure of stable renal function. Results: Levels of MDA were increased before the transplantation in all renal patients. (7.81+/-4.69) Immunosuppressive combined therapy with CsA- Mycophenolate mofetil within I and 6 months was not associated with variability in oxidative stress expression. (Group A MDA: 8.2 vs. 13.1 P=0.15) A statistically significant decrement of MDA levels was observed in Tacrolimus-Mycophenolate mofetil treated patients at 6 months, compared with the preoperative levels.(Group B MDA: 9.2 vs. 4.0, P=0.021) Conclusions: An increased oxidative stress in pretransplant patients suggests an imbalance between toxic oxidants and antioxidants defences. Immunosuppressive combined therapy with CsA was not associated with variability in oxidative stress expression within 1 and 6 months after transplantation. Our study provides strong evidence that Tacrolimus is significantly associated with improved free radical metabolism.