Abstract

Objectives: Cyclosporine and tacrolimus are calcineurin inhibitors that are used to prevent acute rejection in renal transplant recipients. The lymphocyte immunosuppressant sensitivity test (LIST) can predict the pharmacological efficacy of these immunosuppressive agents for renal transplant recipients. There is a correlation between cyclosporine and tacrolimus pharmacological efficacy as evaluated by LIST by the 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) assay procedure prior to renal transplantation. However, the LIST can also evaluate patients before and after the transplantation. Materials and methods: The present study examined the relationship between cyclosporine and tacrolimus pharmacological efficacy by LIST using the MTT assay in 16 renal transplant recipients at 1, 3 and 12 months after transplantation, as well as before the operation. Results: The relationship of cyclosporine and tacrolimus pharmacological efficacy gave a significant Kendall and Spearman’s coefficient correlation in these transplant recipients by the LIST using the MTT assay procedure immediately prior to renal transplantation (r_k = 0.711, r_s = 0.877, p < 0.01). Furthermore, correlations between the cyclosporine and tacrolimus IC50 values were also observed with a significant Kendall and Spearman’s coefficient correlation at 1 and 12 months after transplantation (r_k1month = 0.65, r_s1month = 0.829, p < 0.01, and k_12month = 0.433, r_s12month = 0.603, p < 0.01, respectively). However, no statistically significant relationship was observed between the pharmacological efficacies of the calcineurin inhibitors at 3 months after transplantation (r_k3month = 0.117, r_s3month = 0.1, p > 0.05). Conclusions: Both cyclosporine and tacrolimus exhibit pharmacological efficacy by the inhibition of calcineurin. However, the correlation between cyclosporine and tacrolimus pharmacological efficacies may be altered, due to immunosuppressive therapy or clinical events at 3 months after renal transplantation.

Author Details

Authors

• K. Sugiyama¹
• K. Isogai¹
• A. Toyama¹
• H. Satoh¹
• K. Saito¹
• Y. Nakagawa¹
• M. Tasaki²
• K. Takahashi²
• T. Hirano³

Departments

• ¹ Division of Pharmacy, Niigata University Medical and Dental Hospital,
• ² Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, and
• ³ Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Hachioji, Japan

Address

Dr. K Sugiyama
Division of Pharmacy
Niigata University Medical and Dental Hospital
754 Asahimachi-dori 1-bancho Chuo-ku Niigata City
Niigata 951-8520, Japan
Email: [email protected]

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