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The Host Response to Grafts and Transplantation Immunology
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Cyclosporine A and FK506 are fungal metabolites. These two drugs have a relatively selective effect on helper T lymphocytes. They block T cell proliferation by reducing the expression of several cytokine genes, those which rely on activation of the gene by a particular transcription factor. Included in this group of cytokines are interleukin-2, interleukin-4, and tumor neucrosis factor-a. Both Th1 and Th2 helper T cells are affected, and thus, both cellular and humoral immune responses are reduced. However, Cyclosporine A and FK506 interfere only with acute rejection responses and are not effective at all for treatment of chronic rejection. A disadvantage of these two drugs is that they do not stop immune responses once they have begun. Cyclosporine A also has a number of undesirable side effects, including toxic effects on the kidneys and liver. FK506 has fewer side effects, but those it has are similar to those listed above for Cyclosporine A. Both drugs, because they cannot be synthetically made, are very expensive.
Inflammatory Bowel Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Cyclosporin should preferably not be initiated during pregnancy [53, 54]. It has not been found to be teratogenic in humans [65–67]. However, it is associated with SGA, preterm birth, hypertension and seizures [67, 68]. Breastfeeding is not recommended because of potential neonatal nephrotoxicity and immunosuppression [69].
Psoriasis and lichen planus
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Cyclosporin is an immunosuppressive agent and appears to work by inhibiting the synthesis of cytokines by T-lymphocytes. It is also dramatically effective in psoriasis when given in doses of 3–5 mg/kg per day. Its toxic side effects include severe renal damage, hypertension, hyperlipidemia, and hypertrichosis. Its place in the treatment of disabling and severe psoriasis is assured, but great care and constant monitoring are required.
A COVID-19 Risk Reduction Strategy for the Treatment of Acute Vogt-Koyanagi-Harada Disease Utilizing the Antiviral Potential of Cyclosporine
Published in Ocular Immunology and Inflammation, 2023
Makiko Nakayama, Annabelle A Okada, Isami Hayashi, Yoshimasa Ando, Takayo Watanabe, Hiroshi Keino
Table 1 summarizes the patient characteristics and treatment outcomes of all patients. The mean follow-up was 17.0 months (range 9–30 months). All patients received only one STTA administration bilaterally and were prescribed oral cyclosporine at an initial dose of 100 mg/day for patients 1 and 2 (body weight 55 kg), and 50 mg/day for patients 3 (body weight 45 kg) and 4 (body weight 45 kg). In patient 3, the cyclosporine dose was increased to 100 mg/day before successful cataract extraction in both eyes at 16 months, then tapered to 25 mg/day at 21 months (dose unchanged at the 30-month last follow-up). The cyclosporine was tapered to 50 mg/day at 14 months (last follow-up) in patient 2, and tapered to 50 mg/day at 6 months in patient 4 (dose unchanged at the 9-month last follow-up). The cyclosporine dose and duration details for patient 1 are in the Case Report. No recurrences of inflammation were observed, and there were no instances of re-thickening of the central choroidal thickness (measured at each clinic visit) observed over the follow-up duration. All patients continue a slow taper of cyclosporine without serious adverse effects. Mild renal dysfunction and mild anemia in the elderly patients are being managed with medical specialists, and were not judged to be a contraindication to continued cyclosporine therapy. None of the patients have developed late integumentary signs of VKH disease, and none have developed COVID-19 at last follow-up.
‘Transfersome-embedded-gel’ for dual-mechanistic delivery of anti-psoriatic drugs to dermal lymphocytes
Published in Journal of Microencapsulation, 2022
Pooja Todke, Suryanarayana Polaka, Nidhi Raval, Piyush Gondaliya, Vishakha Tambe, Rahul Maheshwari, Kiran Kalia, Rakesh Kumar Tekade
The first evidence of T cell’s role in psoriasis was appreciated after successfully treating the psoriasis patient with cyclosporine A (CyA). The immunosuppressive agent cyclosporin A strongly suppresses T-cell proliferation and enhances the patient quality of life (Mueller and Herrmann 1979). After the effective treatment of psoriasis with the cytotoxic T-lymphocyte-related antigen 4-immunoglobulin, anti-CD4 monoclonal antibody, which inhibited T-cell activity, the potential of the T-cell function in psoriasis was further identified (Cai et al.2012). Advances in psoriasis therapy were noted when the recommendations for standard care of psoriasis were prepared due to the guidelines and the introduction of biological therapeutic delivery systems (Menter et al.2019, Al‐Hammadi et al.2021, Elston 2021, Maul et al.2021). Even though there are several treatment options available to alleviate the signs and symptoms of psoriasis, none of them can entirely cure the illness (Pradhan et al.2018).
Drug survival analysis of dupilumab and cyclosporin in patients with atopic dermatitis: a multicenter study
Published in Journal of Dermatological Treatment, 2022
Maddalena Napolitano, Maria Mariano, Antonio Cristaudo, Stefano Dastoli, Adriana Di Guida, Mario De Lucia, Gianluca Guerrasio, Steven Paul Nisticò, Maria Passante, Flavia Pigliacelli, Gabriella Fabbrocini, Cataldo Patruno
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a prevalence of about 2%–10% in the adult (1). Due to its chronicity, the choice of an effective and safe drug for long-term treatment is essential. In Italy, only cyclosporin and dupilumab are approved for the treatment of AD. Cyclosporin is a traditional immunosuppressive drug efficacious for treating AD, but its use is limited by several adverse event (2). Dupilumab is a monoclonal antibody blocking the effects of both of interleukin (IL)-4 and IL-13, pivotal cytokines in the pathogenesis of atopic diseases (3); it is proven to be effective and safe for long-term treatment of AD (4). For chronic conditions, such as AD, the efficacy and safety of a drug can be evaluated by drug survival (DS) analysis, besides clinical trials and real-life reports (5).