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Verfasst von:Billing, Heiko [VerfasserIn]   i
 Giese, Thomas [VerfasserIn]   i
 Sommerer, Claudia [VerfasserIn]   i
 Zeier, Martin [VerfasserIn]   i
 Feneberg, Reinhard [VerfasserIn]   i
 Meuer, Stefan [VerfasserIn]   i
 Tönshoff, Burkhard [VerfasserIn]   i
Titel:Pharmacodynamic monitoring of cyclosporine A by NFAT-regulated gene expression and the relationship with infectious complications in pediatric renal transplant recipients
Verf.angabe:Heiko Billing, Thomas Giese, Claudia Sommerer, Martin Zeier, Reinhard Feneberg, Stefan Meuer, and Burkhard Tönshoff
E-Jahr:2010
Jahr:28 April 2010
Umfang:8 S.
Fussnoten:Gesehen am 02.02.2023
Titel Quelle:Enthalten in: Pediatric transplantation
Ort Quelle:Oxford [u.a.] : Wiley-Blackwell, 1999
Jahr Quelle:2010
Band/Heft Quelle:14(2010), 7, Seite 844-851
ISSN Quelle:1399-3046
Abstract:Billing H, Giese T, Sommerer C, Zeier M, Feneberg R, Meuer S, Tönshoff B. Pharmacodynamic monitoring of cyclosporine A by NFAT-regulated gene expression and the relationship with infectious complications in pediatric renal transplant recipients. Pediatr Transplantation 2010: 14:844-851. © 2010 John Wiley & Sons A/S. Abstract: Pharmacokinetic monitoring of CsA is unsatisfactory, because at comparable CsA blood concentrations, the frequency and severity of adverse effects vary considerably among patients. We have therefore recently developed a precise, reliable, and robust whole-blood pharmacodynamic assay that measures the suppression of CsA-target genes in T lymphocytes. Because of the different characteristics of CsA pharmacokinetics in children and the higher propensity for infectious complications, this assay requires validation in the pediatric patient population. We therefore quantified in a prospective study of 45 pediatric renal transplant recipients the residual expression of NFAT-regulated genes in lymphocytes by RT-PCR and correlated these findings with the frequency of recurrent infections in the maintenance period post-transplant. Patients with recurrent infections showed a significantly stronger inhibition of NFAT-regulated gene expression (18.2%) than patients without recurrent infections (31.7%; p = 0.012). This difference was specific, because various PK parameters of CsA and the concomitant immunosuppressive therapy were comparable between patients. Multivariate regression analysis showed that patient age and residual NFAT-regulated gene expression were the only independent determinants of recurrent infections. By ROC curve analysis, a cutoff value of 23% residual NFAT-regulated gene expression had the highest sensitivity (71.1%) and specificity (65.4%) for the discrimination of patients with and without recurrent infections. Pharmacodynamic monitoring of CsA by measurement of residual NFAT-regulated gene expression in T lymphocytes has the potential to identify over-immunosuppressed pediatric renal transplant recipients and is therefore a useful tool for the optimization of CsA therapy.
DOI:doi:10.1111/j.1399-3046.2010.01354.x
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1111/j.1399-3046.2010.01354.x
 Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-3046.2010.01354.x
 DOI: https://doi.org/10.1111/j.1399-3046.2010.01354.x
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:cyclosporine A
 immunosuppression
 pediatric renal transplantation
 pharmacodynamic monitoring
K10plus-PPN:183308666X
Verknüpfungen:→ Zeitschrift

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