Individualization of Immunosuppressive Therapy Using Pharmacodynamics, Immunology and Molecular Biology

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To optimize immunosuppressive treatment in individual patients, many biomarkers have been proposed, but there has been very little information about association to clinical outcome data. The most effective immunosuppressive strategies in organ transplantation are based on the inhibition of IL-2 signal by calcineurin inhibitiors and we first evaluated the inhibition of IL-2 mRNA production for each patient by using RT-PCR method. Then we examined individual T-cell sensitivity to each immunosuppressive agent (cyclosporine, tacrolimus, mycophenolic acid, predonisolone) using flow cytometry with CFSE labeling. Patients with high sensitivity to cyclosporine tended to experience viral reactivation. Pretransplant pharmacodynamics could provide useful information on optimal and safe immunosuppressive therapy.