• Annals of Clinical Neurophysiology
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• 제11권1호
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• pp.24-27
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• 2009

Reversible posterior leukoencephalopathy syndrome (RPLS) is an acute encephalopathy, usually characterized by seizures, visual disorder, mental change and reversible posterior white and gray matter lesions on brain magnetic resonance imaging (MRI). Conditions commonly associated with RPLS include acute renal failure, eclampsia, hypertension, immunosuppresion state, and use of intravenous immunoglobulin or chemotherapy, and additional contributing factors. We report the case of RPLS associated with cyclosporine use in lupus nephritis. In this case, it was not clearly elucidated which was main cause of RPLS. We could think RPLS developed maybe due to combined effect of cyclosporine and lupus nephritis.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.271-277
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• 2009

저자들은 스테로이드 의존형 신증후군 환자에서 진단 8년 만에 두경부 종물이 발생, 혈액 검사상 IgE 증가와 호산구 증가, 경부 컴퓨터 단층 촬영으로 기무라병을 진단하였고, 스테로이드로 치료하였으며, cyclosporine을 투여한 이후 장기간 두경부 종물과 신증후군의 재발을 억제할 수 있었기에 문헌고찰과 함께 보고하는 바이다.

• 약학회지
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• 제42권2호
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• pp.181-186
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• 1998

This study was attempted to investigate the pharmacokinetics of cyclosporine (10mg/kg, oral) in rabbits with $CCI_4$ and bile duct ligation-induced hepatic disorder. The area under the curve (AUC) of blood cyclosporine concentration versus time was significantly increased ($CCI_4$-induced hepatic disorder. Elimination rate constant (Kel) was significantly decreased (p<0.05, p<0.01) in rabbits with $CCI_4$ and bile duct ligation-induced hepatic disorder. Volume of distribution (Vdss) and total body clearance (CLtot) were significantly decreased (p<0.01) in rabbits with $CCI_4$-induced hepatic disorder. But Vdss was significantly increased (p4-induced hepatic disorder were 874ng/ml and 2.71 hr, respectively. Cmax and Tmax values in rabbits with bile duct ligation were 105ng/ml and 2.834 hr, respectively. From results of this experiment. It is desirable to do therapeutic drug monitoring of cyclosporine for effective treatment when the cyclosporine is administered to patients with liver disorder m clinical practice.

• 한국임상약학회지
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• 제14권1호
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• pp.11-23
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• 2004

Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.203-210
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• 2004

The purpose of this study was comparing the effectiveness in the topical applications of cyclosporine with that of steroid, the conventional and standard drug in the treatment of oral lichen planus. 21 patients with oral lichen planus were treated with cyclosporine (n=11) or steroid (n=10) by random allocations. They were recalled 2 weeks, 4 weeks, and 8 weeks after initial treatments. In each recall, the lesion size, clinical symptoms like pain or burning sensation, and side effects were evaluated. The differences of these measurements were compared and the effects of each drug were checked. In reticulation types, steroid showed higher effectivity than cyclosporine and this difference was significant statistically. But in erythema type lesions, either drug showed no significant recovery, statistically. However, the effect of cyclosporine was thought to be more effective. The pain of the lesions was significantly decreased by cyclosporine but not by steroid. The decrease of burning sensation was more dependant upon steroid than cyclosporine, but no statistical relationship could be found. There were no clinical side effects. There was limitation to draw in conclusion due to small pool of this study group. But with the results, this suggestion could be proposed that either drug might be superior to another in effectivity in a specific lesion type or patient symptom, so selection and usage of one drug in a specific case could be better than universal application of one drug in all cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권6호
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• pp.311-323
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• 2023

Immunosuppressants are vital in organ transplantation including facial transplantation (FT) but are associated with persistent side effects. This review article was prepared to compare the two most used immunosuppressants, cyclosporine and tacrolimus, in terms of mechanism of action, efficacy, and safety and to assess recent trials to mitigate their side effects. PubMed and Google Scholar queries were conducted using combinations of the following search terms: "transplantation immunosuppressant," "cyclosporine," "tacrolimus," "calcineurin inhibitor (CNI)," "efficacy," "safety," "induction therapy," "maintenance therapy," and "conversion therapy." Both immunosuppressants inhibit calcineurin and effectively down-regulate cytokines. Tacrolimus may be more advantageous since it lowers the likelihood of acute rejection, has the ability to reverse allograft rejection following cyclosporine treatment, and has the potential to reinnervate nerves. Meanwhile, graft survival rates seem to be comparable for the CNIs. To avoid nephrotoxicity, various immunosuppressants other than CNIs have been studied. Despite averting nephrotoxicity, these medications show increases in acute rejection or other types of adverse effects compared to CNIs. FT has been a topic of interest for oral and maxillofacial surgeons, and the postoperative usage of immunosuppressants is crucial for the long-term prognosis of FT. As contemporary transplantation regimens incorporate novel medications along with CNIs, further research is required.

• Childhood Kidney Diseases
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• 제6권2호
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• pp.142-154
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• 2002

목적 : 사이클로스포린(cyclosporine)은 효과적인 면역 억제제로서 현재에는 장기 이식 후 뿐 아니라 다양한 자가면역성 질병에서 그 사용 범위를 넓히고 있다. 신독성은 사이클로스포린의 대표적인 부작용으로서 그 특징적인 조직학적 소견은 간질의 섬유화와 세 동맥의 초자양 변화이다. 간질 섬유화에는 전통적으로 $TGF-{\beta}$가 관여하는 것으로 알려져 있으며 최근에 osteopontin이라는 단백도 관여한다는 사실이 동물 실험을 통해 알려지고 있다. 사이클로스포린에 의한 간질 섬유화에 osteopontin이 관여한다는 사실이 여러 동물실험을 통하여 알려져 있으나 사람에서는 아직까지 분명한 결론을 얻지 못하고 있다. 동일 환자에서 사이클로스포린 치료 전과 후에 두 번 생검을 시행한 신장 조직에서 osteopontin과 $TGF-{\beta}$의 발현을 조사하여 사이클로스포린과 이들의 관계를 밝히는 것이 본 연구의 목적이다. 대상 및 방법 : 연세의대 세브란스 병원 소아과에서 신장 생검으로 미세변화 신증후군으로 진단 받은 19예를 대상으로 하여 사이클로스포린 치료 전 조직 검사 검체를 대조군으로 하고, 치료 후 조직 검사 검체를 비교군으로 하였다. 사구체 메산지움과 세뇨관에서의 osteopontin 발현과 간질에서의 $TGF-{\beta}$ 발현을 면역조직화학염색으로 측정하였다. 결과 : 사이클로스포린 치료 후 사구체 메산지움과 세뇨관에서 osteopontin의 발현이 의의 있게 증가하였지만 간질에서 $TGF-{\beta}$의 증가는 뚜렷하지 않았다. 또한 세뇨관의 osteopontin과 간질의 $TGF-{\beta}$의 변화는 광학현미경으로 관찰되는 간질 섬유화와는 상관관계가 없었다. 따라서 사이클로스포린 사용시 osteopontin의 발현의 증가와 간질 섬유화 간에는 직접적인 연관이 없는 것으로 사료된다. 결론 : 본 연구의 결과 실험 동물에서와는 달리 사람의 신장에서 osteopontin은 간질 섬유화에 직접 관여하기 보다는 신장 손상에 대한 표지자로서의 의미가 있다고 추정된다.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.423.1-423.1
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• 2002

A simple. specific and sensitive method for the determination of cyclosporine A (CsA) in human serum has been developed by a high performance liquid chromatography/diode array detector (DAD) and applied to pharmacokinetic study of CsA. This method involves the use of solid phase extraction procedure following rapid protein precipitation with zinc sulphate from 1 $m\ell$ of human serum, using a disposable $C_{18}$ extraction cartridge. (omitted)

• Journal of Chest Surgery
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• 제28권5호
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• pp.443-446
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• 1995

The present study was designed to determine whether cyclosporine A inhibits Major Histocompatibility Complex Class II antigen[MHC II expression in the allograft rat heart myocardium. In this rat allograft study we also tried to elucidate whether CSA inhibits MHC II in a dose dependent way. Hearts were isolated from LBN rats weighing 200-250 grams and heterotopically transplantated into the abdomen of weight-matched ACI rats. The ACI rats were randomly assigned to one of the three experimental groups according to cyclosporine dosage: {1}control [no CSA , n=6 {2}CSA 5 mg/day , n=5 {3}CSA 10 mg/day, n=5. The transplanted hearts were harvested 5 days postoperatively and analyzed. MHC II expression was detected by indirect immunoperoxidase staining and quantified via computer image analysis system. The % positive area reading was obtained in each slide [50 areas per group and compared to other groups. Significant differences were noted between three groups [p<0.05 . We conclude that CSA inhibits MHC II in heterotopically transplanted allograft rat heart in a dose dependent way.

• 대한수의학회지
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• 제56권1호
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• pp.47-49
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• 2016

An 11-year-old, spayed female poodle presented with fever and shifting lameness. Physical examination revealed hyperthermia ($40.6^{\circ}C$), and proteinuria was detected upon urinalysis. Increased neutrophils (83%) and decreased viscosity were revealed upon synovial fluid analysis. Serum antinuclear antibody was positive at 1 : 80. Based on these findings, the dog was diagnosed with systemic lupus erythematosus. Immunosuppressive therapy was initiated with prednisolone and cyclosporine, and the condition was markedly improved after the treatments. This case report describes the clinical and laboratory findings, imaging characteristics and successful outcomes after prednisolone plus cyclosporine therapy in a canine systemic lupus erythematosus case.