Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab
Basiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2012-03-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.3727/096368911X605493 |
| _version_ | 1818300207124709376 |
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| author | Kentaro Sugiyama Ph.D. Kazuya Isogai Satoshi Horisawa Akira Toyama Hiroshi Satoh Kazuhide Saito Yuki Nakagawa Masayuki Tasaki Kota Takahashi Toshihiko Hirano |
| author_facet | Kentaro Sugiyama Ph.D. Kazuya Isogai Satoshi Horisawa Akira Toyama Hiroshi Satoh Kazuhide Saito Yuki Nakagawa Masayuki Tasaki Kota Takahashi Toshihiko Hirano |
| author_sort | Kentaro Sugiyama Ph.D. |
| collection | DOAJ |
| description | Basiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin inhibitor without basiliximab. Cyclosporine has been generally administered with basiliximab for renal transplant recipients. However, in cases of tacrolimus-based immunosuppressive regimen, the clinical efficacy and safety of combined use of tacrolimus and basiliximab remains to be elucidated. This study evaluated the tacrolimus pharmacological efficacy using a lymphocyte immunosuppressant sensitivity test (LIST) with MTT assay procedures in 16 cases of renal transplant recipients treated by tacrolimus without basiliximab and in 13 cases treated by tacrolimus in combination with basiliximab. The rate of acute rejection episodes in the recipients treated with tacrolimus plus basiliximab was 1/13 (7.7%), whereas the rate in the recipients treated with tacrolimus without basiliximab was 6/16 (37.5%). The recipients were divided into two groups according to their peripheral blood mononuclear cell (PBMC) sensitivity to tacrolimus [i.e., including a tacrolimus high sensitivity group (IC 50 <1.0 ng/ml) and a low sensitivity group (IC 50 >1.0 ng/ml). In the recipients treated with tacrolimus without basiliximab, the rate of acute rejection episodes in the tacrolimus high sensitivity group was 1/10 (10.0%), which was significantly lower than the rate in the low sensitivity group of 5/6 (83.3%; p = 0.008). The incidence of cytomegalovirus infection was not significantly different between the tacrolimus high and the low sensitivity groups of the recipients treated with tacrolimus with and without basiliximab. Therefore, in the case of selected tacrolimus-based immunosuppressive therapy for renal transplant recipients, the tacrolimus pharmacological efficacy should be evaluated using LIST at a time just before the transplant procedure in order to accurately predict allograft rejection. The data also suggested that low tacrolimus sensitivity recipients should be treated with tacrolimus-based immunosuppressive therapy in combination with basiliximab. |
| first_indexed | 2024-12-13T05:03:27Z |
| format | Article |
| id | doaj.art-21dafdf17c7e409bb009ffdf634ae830 |
| institution | Directory Open Access Journal |
| issn | 0963-6897 1555-3892 |
| language | English |
| last_indexed | 2024-12-13T05:03:27Z |
| publishDate | 2012-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cell Transplantation |
| spelling | doaj.art-21dafdf17c7e409bb009ffdf634ae8302022-12-21T23:58:43ZengSAGE PublishingCell Transplantation0963-68971555-38922012-03-012110.3727/096368911X605493Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without BasiliximabKentaro Sugiyama Ph.D.0Kazuya Isogai1Satoshi Horisawa2Akira Toyama3Hiroshi Satoh4Kazuhide Saito5Yuki Nakagawa6Masayuki Tasaki7Kota Takahashi8Toshihiko Hirano9 Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Tokyo, Japan Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan Division of Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan Division of Urology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Tokyo, JapanBasiliximab is a recently developed immunosuppressive agent for the prevention of acute allograft rejection in renal transplant recipients. The combination use of basiliximab and a calcineurin inhibitor was suggested to be more effective in comparison to immunosuppressive therapy using calcineurin inhibitor without basiliximab. Cyclosporine has been generally administered with basiliximab for renal transplant recipients. However, in cases of tacrolimus-based immunosuppressive regimen, the clinical efficacy and safety of combined use of tacrolimus and basiliximab remains to be elucidated. This study evaluated the tacrolimus pharmacological efficacy using a lymphocyte immunosuppressant sensitivity test (LIST) with MTT assay procedures in 16 cases of renal transplant recipients treated by tacrolimus without basiliximab and in 13 cases treated by tacrolimus in combination with basiliximab. The rate of acute rejection episodes in the recipients treated with tacrolimus plus basiliximab was 1/13 (7.7%), whereas the rate in the recipients treated with tacrolimus without basiliximab was 6/16 (37.5%). The recipients were divided into two groups according to their peripheral blood mononuclear cell (PBMC) sensitivity to tacrolimus [i.e., including a tacrolimus high sensitivity group (IC 50 <1.0 ng/ml) and a low sensitivity group (IC 50 >1.0 ng/ml). In the recipients treated with tacrolimus without basiliximab, the rate of acute rejection episodes in the tacrolimus high sensitivity group was 1/10 (10.0%), which was significantly lower than the rate in the low sensitivity group of 5/6 (83.3%; p = 0.008). The incidence of cytomegalovirus infection was not significantly different between the tacrolimus high and the low sensitivity groups of the recipients treated with tacrolimus with and without basiliximab. Therefore, in the case of selected tacrolimus-based immunosuppressive therapy for renal transplant recipients, the tacrolimus pharmacological efficacy should be evaluated using LIST at a time just before the transplant procedure in order to accurately predict allograft rejection. The data also suggested that low tacrolimus sensitivity recipients should be treated with tacrolimus-based immunosuppressive therapy in combination with basiliximab.https://doi.org/10.3727/096368911X605493 |
| spellingShingle | Kentaro Sugiyama Ph.D. Kazuya Isogai Satoshi Horisawa Akira Toyama Hiroshi Satoh Kazuhide Saito Yuki Nakagawa Masayuki Tasaki Kota Takahashi Toshihiko Hirano Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab Cell Transplantation |
| title | Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab |
| title_full | Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab |
| title_fullStr | Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab |
| title_full_unstemmed | Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab |
| title_short | Comparative Study of the Cellular Pharmacodynamics of Tacrolimus in Renal Transplant Recipients Treated with and without Basiliximab |
| title_sort | comparative study of the cellular pharmacodynamics of tacrolimus in renal transplant recipients treated with and without basiliximab |
| url | https://doi.org/10.3727/096368911X605493 |
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