• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.04a
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• pp.246-246
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• 2009

• Journal of Veterinary Clinics
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• v.26 no.4
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• pp.340-343
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• 2009

A 3-year-old, intact female Poong-san dog was presented with a 4-month history of erosive, erythematous dermatitis unresponsive to systemic antibiotics and glucocorticoids. Crust, erosion, and alopecia were noted on the ear pinnae, bridge of nose, and forelimb. Cytological evaluation of intact pustules showed isolated free-floating rounded acantholytic keratinocytes admixed with non-degenerated neutrophils and eosinophils. Results of histopathologic examination revealed the intra-epidermal pustules with predominant neutrophils, less eosinophils, and isolated and clustered acantholytic cells. A diagnosis of pemphigus foliaceus (PF) was made based on the history, clinical, cytological and histopathological results. The skin lesions had improved after systemic cyclosporine therapy. This case report demonstrates that cyclosporine, an immunosuppressive agent, can be used in the management of PF in dogs.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.108-111
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• 2014

A 7-year-old spayed female domestic shorthair cat was referred for chronic intermittent vomiting. The frequency of vomiting increased recently, and the cat showed anorexia at presentation. There were no remarkable abnormalities on the blood analyses and diagnostic imaging. However, the endoscopic examination revealed focal erosions of the gastric body mucosa, and subsequent multiple biopsies were obtained. Histopathologic examination indicated mild to moderate lymphocytic gastritis. The vomiting was completely disappeared 7 days after the administration with prednisolone (PDS). However, because of side effects caused by the long-term PDS administration, cyclosporine was added on the prescription with tapered dose of PDS. The dog's condition improved with continued cyclosporine treatment, and no further vomiting and anorexia episodes have been noted. This case describes the successful management with administration of cyclosporine in feline lymphocytic gastritis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.445-453
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• 2006

Cyclosporine A (CsA) is a powerful immunosuppresive agent used to prevent graft rejection of organ and treat autoimmune disease. One of the major side effects associated with CsA treatment is the development of gingival overgrowth. The purpose of this study was to investigate the mRNA expression and association of the several growth factors in gingival overgrowth induced by CsA, respectively. Gingival fibroblasts were obtained from gingival tissues of healthy donor and the patients treated with CsA. The cultured gingival fibroblasts were incubated with increasing concentrations of CsA for 24 hours, and the expression of MMP-1, TIMP-1, $TGF-{\beta}_1$, p21 were determined by reverse transcription-polymerase chain reaction (RT-PCR). The expressions of MMP-1 was slightly increased according to the concentration of treated CsA, but there was no statistical significance. TIMP-1 showed the increased expression at the CsA concentration of 250 and 500 ng/ml and significantly decreased at the CsA concentration of 750ng/ml. $TGF-{\beta}_1$ showed the increased expression at the CsA concentration of 500 and 750 ng/ml. The expression of p21 was not changed significantly. We concluded that the gingival hyperplasia induced by CsA was more related with $TGF-{\beta}_1$ than MMP-1 or TIMP-1 on gingival collagen metabolism in patients treated with CsA.

• Childhood Kidney Diseases
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• v.20 no.2
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• pp.97-100
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• 2016

Toxic epidermal necrolysis (TEN) is a rare, acute, serious, and potentially fatal skin disease, in which cell death causes the epidermis to separate from the dermis. It is thought to be a hypersensitivity complex that affects the skin and mucous membranes, and is caused by certain medications, infections, genetic factors, underlying immunologic disease, or more rarely, cancers. We report two cases of TEN associated with deflazacort (DFZ), a derivative of prednisolone, used in the first episode of nephrotic syndrome (NS). The skin eruption appeared on the $4^{th}$ and $5^{th}$ weeks after DFZ administration, while NS was in remission. The widespread lesions were managed by intensive supportive treatment, discontinuation of DFZ, and oral administration of cyclosporine. Both patients showed a rapid improvement in symptoms of TEN without any complications or relapse of NS.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.476-480
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• 2005

Immunosuppressive therapy in pediatric renal transplant recipients is changing consequence of the increasing number of available immunosuppressive agents. The optimal use of immunosuppressive agents requires a thorough understanding of the pharmacokinetic characteristics, but the information on the pharmacokinetic characteristics of these drugs in pediatric transplant recipients is still limited. In general, patients younger than 5 years old show higher clearance rates, therefore the need for higher dosages in younger patients seems evident. By the therapeutic drug monitoring, trough($C_{min}$) and peak level($C_{max}$) are measured and the area under the blood concentration-time curve(AUC), which is taken as being representative of total systemic exposure can be calculated. Cyclosporine A (CSA) has poor bioavailability, which contributes to high inter- and intra-patient pharmacokinetic variability. CSA concentration measured 2 hours after administration($C_2$) has better correlation with the AUC than $C_{min}$ and is an alternative technique that predicts the AUC. Tacrolimus(Tac) has a great deal of inter-individual variability like CSA but intra-individual variability in systemic exposure is considered to be low. Both CSA and Tac are metabolized by a cytochrome P-450 enzyme isoform(CYP3A4). We should consider changing the dosages when CSA or Tac is used in combination with the medicines that inhibit or induce the CYP3A4. In case of steroid-free immunosuppressive therapy, the blood concentration of Tac should be frequently checked and dosage adjustment may be needed.

• The Korean Journal of Pharmacology
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• v.31 no.2
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• pp.233-239
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• 1995

To verify the effect of immunosuppressants on the endotoxin-induced increase in iNOS activity, the action of immunosuppressants, dexamethasone (1.5 mg/kg), azathioprine (5 mg/kg/day) and cyclosporine (10 mg/kg), were evaluated in mice pretreated with LPS. The intraperitoneal injection of lipopolysaccharide (10 mg/kg) increased the nitric oxide synthase (NOS) activity in the brain and liver to maximum at 1 and 3 hours, respectively. The increase in NOS activity was blocked by the treatment with NOS inhibitor, LNAME(300 mg/kg) and aminoguanidine(100 mg/kg); a protein inhibitor, cycloheximide (10 mg/kg); and a transcription inhibitor of inducible NOS(iNOS), dexamethasone(1.5 mg/kg). Immunosuppressants, azathioprine (5 mg/kg) and cyclosporine (10 mg/kg), effectively blocked the increase in NOS activity. These results suggest that iNOS expression plays an important role in LPS-induced the increase in NOS activity and that immunosuppressants can be used as candidate for therapeutic agents in endotoxemia.

• Childhood Kidney Diseases
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• v.14 no.1
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• pp.100-104
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• 2010

We report on two children with a high risk of recurrent focal segmental glomerulosclerosis (FSGS) after renal transplantation that could be effectively prevented by prophylactic administration of cyclosporine combined with preemptive plasmapheresis prior to renal transplantation.

• Journal of Veterinary Clinics
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• v.28 no.4
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• pp.438-441
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• 2011

A 7-year-old castrated, domestic shorthair cat was presented with a 2-year history of chronic nasal discharge and sneezing. Upon presentation, bilateral mucopurulent nasal discharge and stertorous respiration were marked. Physical examination revealed a tachypnea. Oral examination was unremarkable and chest radiology was normal. Findings of nasal cytology and skull radiology were not specific and further imaging technique, endoscopic examination and histopathology was performed for a definite diagnosis. Fluid, and/or soft tissue opacity was found in bilateral nasal cavity, nasopharyngeal regions and right side tympanic bulla through the CT scan. No evidence of neoplasia was revealed. A rigid rhinoscopy, flexible bronchoscopy and otoscopy was used for the visualization of the lesions and tissue biopsy biopsy was performed for histopathology. On histopathological examination, the nasal mass consisted mainly of large numbers of plasma cells and lymphocytes. And the final diagnosis was lymphoplasmacytic rhinitis based on histopathologic examination. Long term management with oral cyclosporine (5 mg/kg, BID) was safe and successful in this cat. This is the first case report described clinical and diagnostic characteristic features of feline lymphoplasmacytic rhinitis and its clinical outcome using oral cyclosporine in Korea.

• Journal of Pharmaceutical Investigation
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• v.40 no.5
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• pp.263-267
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• 2010

Nanoemulsions have been widely investigated for many years because of their attractive and unique characteristics. Nanoemulsions are composed of oil, surfactant, co-surfactant and water. Especially, cosurfactant plays a critical role in formation of nanoemulsions. In pharmaceutical area, a pre-concentrate form of nanoemulsions which is known as self-nanoemulsifying drug delivery systems (SNEDDS) was available for some water-insoluble drugs. In this study, we investigated the functional behaviors of cosurfactant in design of SNEDDS and nanoemulsions. Cremophor RH 40$^{(R)}$, Propylene carbonate and medium chain triglyceride were selected for surfactant, cosurfactant and oil, respectively. Cyclosporine was employed as a drug. Phase diagrams showed the area of isotropic o/w region which forms o/w nanoemulsions was not significantly affected by the compositional ratio of cosurfactant. But, drug solubilization capacity, droplet size of nanoemulsions and drug release rate were greatly affected by the cosurfactant.