Evaluation of interleukin-2 mRNA in whole blood as a parameter for monitoring cyclosporine pharmacodynamics

Biol Pharm Bull. 2009 Apr;32(4):604-8. doi: 10.1248/bpb.32.604.

Abstract

Inhibition of cytokine production is the main immunosuppressive effect of cyclosporine (CsA), which is widely used in organ transplantation. Pharmacodynamic (PD) assay for evaluating the inhibition of interleukin-2 (IL-2) production for each patient could provide a more appropriate dosing regimen. We measured the suppression of IL-2 mRNA expression in whole blood following the addition of a range of CsA concentrations by a real-time reverse transcription-polymerase chain reaction (RT-PCR) method. Individual CsA sensitivity on the IL-2 mRNA expression was assessed with healthy subjects both in vitro and ex vivo. We also evaluated it in pre-transplant patients before taking immunosuppressive drugs. Sigmoid E(max) model was used to analyze the relationship between CsA concentration and IL-2 mRNA expression. The assay was completed within 8 h. The concentration that resulted in IC(50) showed high reproducibility and specificity among the healthy subjects (p<0.005, n=5). Ex vivo study indicated similar inhibition profiles to those of in vitro studies (n=3). The values of IC(50) obtained from patients (n=22) also showed large variations and were significantly lower than those from healthy subjects (p<0.05). Semi-quantitative RT-PCR was considered to be a rapid and reliable assay. Our data imply that measurement of IL-2 mRNA levels in whole blood could be valuable in monitoring CsA PD in transplant patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Anti-Inflammatory Agents / pharmacology
  • Cyclosporine / pharmacokinetics*
  • Cyclosporine / pharmacology*
  • Drug Monitoring
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / pharmacology*
  • Interleukin-2 / biosynthesis*
  • Kidney Transplantation / immunology
  • Male
  • Middle Aged
  • Prednisolone / pharmacology
  • RNA, Messenger / blood*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Interleukin-2
  • RNA, Messenger
  • Cyclosporine
  • Prednisolone