Monitoring of cyclosporine therapy with in vitro biological assays

Thomas P. Lennon, Gary C. Yee, Michael S. Kennedy, Beverly Torok-Storb, Samuel A. Burstein, H. Joachim Deeg

Research output: Contribution to journalArticle

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Abstract

We examined the correlation between cyclosporine (CsA) levels and in vitro assays of immune function and hematopoiesis. Mixed lymphocyte reaction (MLR), mitogen responses, suppressor cell (SC), cell-mediated lympholysis (CML), and erythroid colony (EC) assays were studied in dogs, and in vitro megakaryocytopoiesis was studied in mice. Serum CsA concentrations were measured by radioimmunoassay. After oral or intramuscular CsA dosing, lymphocyte proliferation, as measured by MLR, inversely correlated with in vivo serum CsA concentration. MLR responses decreased rapidly, and nearly complete inhibition coincided with peak CsA levels. While CsA concentration-related suppression of lymphocyte stimulation was also observed in mitogen-stimulated cultures, results were less predictable and similar to results with in vitro CsA addition, and higher serum CsA levels were required to achieve comparable suppression. In vivo serum or in vitro CsA levels >300 ng/ml completely inhibited the development of cytotoxic effector cells but had no meas-ureable effect on the expression of suppressor cells in the same cultures. Furthermore, CsA serum also caused concentration-related inhibition of EC growth. The addition of human embryonic kidney-conditioned medium, however, abrogated CsA-related inhibition of EC growth, which suggested that CsA indirectly inhibited EC growth, presumably by interfering with CsA-sensitive accessory cells. This was supported by studies in an in vitro model of murine megakaryocytopoiesis. In normal conditioned medium, megakaryocyte colonies were unaffected by the presence of CsA. However, when cells were cultured in conditioned medium prepared in the presence of CsA, profound inhibition of megakaryocyte growth was observed. These studies show that biologic assays can be used reliably to measure concentration-related changes in immunosuppressive activity of CsA. Further clinical studies are needed to evaluate the usefulness of pharmacodynamic monitoring of CsA therapy.

Original languageEnglish (US)
Pages (from-to)799-804
Number of pages6
JournalTransplantation
Volume44
Issue number6
DOIs
StatePublished - Dec 1987

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Biological Assay
Cyclosporine
Mixed Lymphocyte Culture Test
Conditioned Culture Medium
Thrombopoiesis
Serum
Megakaryocytes
Growth
Mitogens
Therapeutics
Hematopoiesis
Immunosuppressive Agents
Lymphocyte Activation
Radioimmunoassay
Cultured Cells
In Vitro Techniques
Dogs
Lymphocytes
Kidney

ASJC Scopus subject areas

  • Transplantation

Cite this

Lennon, T. P., Yee, G. C., Kennedy, M. S., Torok-Storb, B., Burstein, S. A., & Deeg, H. J. (1987). Monitoring of cyclosporine therapy with in vitro biological assays. Transplantation, 44(6), 799-804. https://doi.org/10.1097/00007890-198712000-00016

Monitoring of cyclosporine therapy with in vitro biological assays. / Lennon, Thomas P.; Yee, Gary C.; Kennedy, Michael S.; Torok-Storb, Beverly; Burstein, Samuel A.; Deeg, H. Joachim.

In: Transplantation, Vol. 44, No. 6, 12.1987, p. 799-804.

Research output: Contribution to journalArticle

Lennon, TP, Yee, GC, Kennedy, MS, Torok-Storb, B, Burstein, SA & Deeg, HJ 1987, 'Monitoring of cyclosporine therapy with in vitro biological assays', Transplantation, vol. 44, no. 6, pp. 799-804. https://doi.org/10.1097/00007890-198712000-00016
Lennon, Thomas P. ; Yee, Gary C. ; Kennedy, Michael S. ; Torok-Storb, Beverly ; Burstein, Samuel A. ; Deeg, H. Joachim. / Monitoring of cyclosporine therapy with in vitro biological assays. In: Transplantation. 1987 ; Vol. 44, No. 6. pp. 799-804.
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