Cyclosporine A is the main immunosuppressant used after kidney transplantation. Cyclosporine A inhibits the proliferation of IL-2-dependent active T lymphocytes,** mainly nephrotoxicity, hepatotoxicity, hirsutism, gingival hyperplasia, hyperuricemia, and gout attacks (especially when combined with loop diuretics). Cyclosporine is a potent and selective immunosuppressant that acts primarily at T cell function by suppressing it. T cells play a key role in the complex immune system, both helping to fight off infections and, in some cases, leading to autoimmune diseases. It is by reversibly altering lymphocyte function that Cyclophin achieves precise control of T cells.
How does cyclosporine work?
Cyclosin can inhibit the differentiation and proliferation of lymphocytes under antigen or progen stimulation, thereby preventing them from over-activating and avoiding excessive immune responses. It's like putting brakes on a galloping carriage so that it doesn't get out of control. At the same time, cyclosporine can also inhibit the secretion of cytokines by lymphocytes, such as interleukin-2 and interferon, which play an important role in the immune response.
In addition, cyclosporine can also inhibit the killing activity of NK cells. NK cells are the rapid response force of the body's immune system, which can recognize and destroy virus-infected cells or malformed cells. This effect of cyclophin prevents overactivation of NK cells, thus preventing the emergence of autoimmune reactions.
In terms of application, cyclosporine can be combined with adrenocorticosteroids or other immunosuppressants to provide new and effective means for a variety of autoimmune diseases. For example, cyclosporine has certain efficacy for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, nephrotic chronic nephritis, autoimmune hemolytic anemia, psoriasis, uveitis, etc.
Why does cyclosporine test blood levels?
Cyclosporine needs to be detected for incomplete absorption in the gastrointestinal tract, so administration at the same time as food will promote the absorption of the drug, and the bioavailability of the drug will be enhanced accordingly. The incomplete absorption of cyclosporine is related to its metabolism in the small intestinal wall, and cyclosporine is oxidatively metabolized in liver microsomes through the cytochrome P450 A isoenzyme system, which is also expressed in the small intestinal wall, which explains the first-pass effect of cyclosporine A. The bioavailability of cyclosporine A varies greatly from individual to individual, and the therapeutic window is very narrow, so plasma concentrations of cyclosporine should be measured periodically.
Precautions for the use of cyclosporine and pentaesters together?
Pentaester capsules are a type of medication that is commonly used to increase drug concentrations, usually one pill at a time, twice a day, with cyclosporine. This drug can effectively increase the concentration of the drug, so as to better exert the best effect of the drug. The combination can reduce the dose of cyclosporine and reduce the financial burden on patients. Clinically, the following points need to be noted:
1. Normal liver function is a prerequisite for taking pentaester capsules, because the liver is an important metabolic organ in the human body, and drugs need to be metabolized and converted in the liver. If the liver function is not normal, it may affect the metabolism and transformation of the drug, thus affecting the ** effect of the drug.
2. When the dosage of cyclosporine is very large and the concentration is not very high, you can consider using pentaester capsules to increase the concentration of the drug. If the concentration of cyclosporine is already high, then the use of pentaesters may increase the risk.
3. When you start taking pentaester capsules, you need to immediately reduce the amount of cyclosporine to avoid excessive burden on the body. After a week, you need to go to the hospital to take blood to test the blood concentration of cyclosporine, and adjust the medication regimen according to the concentration. If the concentration is too high, it is necessary to continue to reduce the amount of cyclosporine;If the concentration is too low, you will need to increase the amount of cyclosporine. By constantly adjusting the medication regimen, after about a month, it can basically stabilize.
Cyclosporine interactions of other nutrients?
Cyclosporine A is a highly effective, safe and broad-spectrum immunosuppressant, which is widely used in organ transplantation, autoimmune diseases and other fields. However, the absorption and metabolism of cyclosporine is affected by a variety of factors, one of which is fat intake. Cyclosporine A is a highly fat-soluble drug that binds to lipoproteins in about 40% of plasma. Thus, fat intake may promote the absorption of cyclosporine in the gastrointestinal tract, resulting in an increase in its plasma concentration. However, it has also been reported that fats in food do not promote the absorption of cyclosporine in the gastrointestinal tract.
In clinical studies, cyclosporine A can be absorbed by the gastrointestinal tract when given a water-soluble form of vitamin E (d-a-succinate polyethylene glycol vitamin E) at the same time as cyclosporine A in children after liver transplantation. However, vitamin E in food alone does not have a role in promoting cyclosporine absorption, nor has the effect of vitamin E in enhancing cyclosporine A after kidney transplantation.
In addition to this, some fruit juices such as grape juice can affect the metabolism of cyclosporine. Certain components in grape juice may affect the metabolism of cyclosporine, leading to an increase in its plasma concentration. However, the specific mechanism of this effect is unclear and further research is needed to confirm it. In summary, the absorption and metabolism of cyclosporine is affected by a variety of factors, including fat intake, vitamin E intake, and some fruit juices such as grape juice. Therefore, in clinical application, we need to consider the influence of these factors on the pharmacokinetics of cyclosporine to better adjust the drug regimen and ensure the maximum efficacy of the drug.
Cyclosporine A is the main immunosuppressant used after kidney transplantation, and it has certain efficacy in autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, nephrotic chronic nephritis, autoimmune hemolytic anemia, psoriasis, and uveitis. If you have any questions during the use of cyclosporine, please leave a message to discuss.
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