| Online-Ressource |
Verfasst von: | Billing, Heiko [VerfasserIn]  |
| Giese, Thomas [VerfasserIn]  |
| Sommerer, Claudia [VerfasserIn]  |
| Zeier, Martin [VerfasserIn]  |
| Feneberg, Reinhard [VerfasserIn]  |
| Meuer, Stefan [VerfasserIn]  |
| Tönshoff, Burkhard [VerfasserIn]  |
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 |
Pharmacodynamic monitoring of cyclosporine A by NFAT-regulated gene expression and the relationship with infectious complications in pediatric renal transplant recipients / Billing, Heiko [VerfasserIn]; 28 April 2010 (Online-Ressource)