EXPLORATION OF C-2 LEVELS IN MAINTENANCE PHASE RENAL TRANSPLANT PATIENTS

肾移植维持期患者C-2水平探讨

• 批准号: 7380419
• 负责人: John C. Curtis
• 金额: $ 0.19万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7380419
• 关键词: EXPLORATION; LEVELS; MAINTENANCE; PHASE; RENAL

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We currently follow over 4,000 kidney transplant patients in the outpatient clinic at the University of Alabama Medical Center in Birmingham. The vast majority of these patients are taking cyclosporine as maintenance immunosuppression. Cyclosporine has been the cornerstone of immunosuppression for solid organ transplant recipients since its introduction into routine clinical practice. However, cyclosporine has not been reached the full therapeutic potential due to its low oral absorption and high intra- and inter-patient variability of absorption and exposure. Traditionally, pre-dose blood concentration monitoring has been utilized as a way to titrate the cyclosporine dose to a designated range that is considered therapeutic with acceptable tolerability. This state is complicated by a narrow therapeutic index of cyclosporine evidenced by the presence of either acute rejection or nephrotoxicity in patients having cyclosporine trough concentrations within the target range. Recently, there has been speculation that looking at the level of cyclosporine around the peak absorption time, 2 hours after ingesting cyclosporine, may be a more useful basis for adjusting dose. However, information in this area is not sufficiently defined. This project will be dependent on accurate sampling times and documentation which can be performed in the GCRC.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。我们目前在伯明翰的亚拉巴马大学医学中心的门诊部随访了4,000多名肾移植患者。这些患者中的绝大多数正在服用环孢素作为维持免疫抑制剂。自引入常规临床实践以来，环孢菌素一直是实体器官移植受者免疫抑制的基石。然而，环孢霉素尚未达到充分的治疗潜力，由于其口服吸收低，吸收和暴露的患者内和患者间变异性高。 传统上，给药前血药浓度监测已被用作将环孢霉素剂量滴定至被认为具有可接受耐受性的治疗性的指定范围的方法。这种状态由于环孢菌素的治疗指数狭窄而变得复杂，这一狭窄的治疗指数由环孢菌素谷浓度在目标范围内的患者中存在急性排斥反应或肾毒性所证明。最近，有猜测认为，观察环孢素在吸收高峰时间前后的水平，即服用环孢素后2小时，可能是调整剂量的更有用的依据。然而，这方面的信息没有得到充分界定。 本项目将取决于准确的采样时间和可在GCRC中执行的文件。