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Härtel, C; Hammers, HJ; Schlenke, P; Fricke, L; Schumacher, N; Kirchner, H; Müller-Steinhardt, M.
Individual variability in cyclosporin A sensitivity: the assessment of functional measures on CD28-mediated costimulation of human whole blood T lymphocytes.
J Interferon Cytokine Res. 2003; 23(2):91-99 Doi: 10.1089/107999003321455480
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Co-authors Med Uni Graz: Schlenke Peter
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Abstract:: The quantitative analysis of cyclosporin A (CsA) effects might be helpful for optimizing immunosuppressive treatment after allogeneic organ transplantation in individual patients, as rejection can occur despite the existence of CsA blood levels within therapeutic ranges. Previous investigations found that costimulation of the CD28 pathway generally mediates CsA-resistant proliferation of T cell receptor (TCR)-activated T lymphocytes. However, here we describe considerable interindividual variation regarding the immunosuppressive effects of CsA (1000 microg/L) on anti-CD3/CD28 T cell costimulation in a human whole blood assay. In the in vitro study, we found a significant reduction of T cell proliferation, activation marker expression (CD25, CD69) on the T cell surface, and interleukin-2 (IL-2) protein expression in whole blood samples of all healthy subjects (n = 11). However, the investigation of cytokine mRNA profiles revealed variable results of in vitro CsA sensitivity. Whole blood samples of 3 of 11 healthy individuals demonstrated a marked suppression of IL-2 mRNA expression (>50%) and a partial inhibition of IL-4, interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha) mRNA expression on addition of CsA. In contrast, the remaining 8 healthy individuals had cytokine mRNA expression levels that were unaffected or even increased when CsA was administered in vitro. In patients undergoing CsA monotherapy (ex vivo study, n = 9), we found a significant suppression of IL-2 mRNA levels in 4 of 9 patients ex vivo. Thus, we cannot confirm a universal CsA resistance of T cells on anti-CD3/CD28 costimulation. Instead, our results suggest an individual degree of CsA sensitivity that might be more consistent with clinical experience. Prospective studies are necessary to determine if individual degrees of CsA sensitivity correlate with clinical events and are associated with a low or high risk of transplant rejection.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Antibodies, Monoclonal - immunology; Antigens, CD - drug effects Antigens, CD - immunology; Antigens, CD28 - immunology; Antigens, Differentiation, T-Lymphocyte - drug effects Antigens, Differentiation, T-Lymphocyte - immunology; Biological Markers -; Blood Cells - immunology; Cell Division - drug effects; Cells, Cultured -; Cyclosporine - blood Cyclosporine - pharmacology Cyclosporine - therapeutic use; Dose-Response Relationship, Drug -; Female -; Gene Expression Regulation -; Genetic Variation -; Humans -; Immunosuppressive Agents - blood Immunosuppressive Agents - pharmacology Immunosuppressive Agents - therapeutic use; Interferon-gamma - antagonists & inhibitors Interferon-gamma - drug effects; Interleukin-2 - biosynthesis Interleukin-2 - blood Interleukin-2 - genetics; Interleukin-4 - antagonists & inhibitors Interleukin-4 - blood Interleukin-4 - genetics; Kidney Transplantation -; Lectins, C-Type -; Lymphocyte Activation -; Male -; RNA, Messenger - metabolism; Receptors, Interleukin-2 - drug effects Receptors, Interleukin-2 - immunology; T-Lymphocytes - immunology T-Lymphocytes - metabolism; Tumor Necrosis Factor-alpha - antagonists & inhibitors Tumor Necrosis Factor-alpha - drug effects