Medicines Cyclosporine

Antibodies have and likely will find additional use in transplantation-related medicine. In general, cell-mediated immunological mechanisms are responsible for mediating rejection of transplanted organs. In many instances, transplant patients must be maintained on immunosuppressive drugs (e.g. some steroids and, often, the fungal metabolite cyclosporine). However, complications may arise if a rejection episode is encountered that proves unresponsive to standard immunosuppressive therapy. Orthoclone OKT-3 was the first monoclonal antibody-based product to find application in this regard. 

Christians U, First MR, Benet LZ (2000) Recommendations for bioequivalence testing of cyclosporine generics revisited. Ther Drug Monit 22 330-335 CPMP (2000) European Medicines Agency. Committee for Proprietary Medicinal Products. Note for guidance on the investigation on bioavailability and bioequivalence. CPMP/EWP/QWP/1401/98.http //www.emea.europa.eu/pdfs/human/qwp/140198en.pdf. Cited 30 Dec 2008... 

Natural products have been identified as the active principle of herbs and extracts used in folk medicine [1], The importance of natural products in the pharmaceutical industry has continued to the present day and is reflected by the fact that close to half of the best selling pharmaceuticals are either natural products (e.g. cyclosporine, Taxol, FK 506) or derivatives thereof [3]. In high throughput screening processes performed by the pharmaceutical industry natural product extracts exhibit a hit rate which is estimated to be substantially higher than the hit rate of random libraries from combinatorial chemistry. Natural products such as epothilones, discodermolide or ecteinascidin are promising clinical candidates for future cancer treatment. 

Maki DG, Fox BC, Kuntz J, Sollinger HW, Belzer FO. A prospective, randomized, double-blind study of trimethoprim-sulfamethoxazole for prophylaxis of infection in renal transplantation. Side effects of trimethoprim-sulfamethoxazole, interaction with cyclosporine.The Journal of laboratory and clinical medicine. 1992 Jan l 19(1 ) 11-24. 

Avent CK, Krinsky D, Kirklin JK, Bourge RC, Figg WD. Synergistic nephrotoxicity due to ciprofloxacin and cyclosporine.The American journal of medicine. 1988 Sep 85(3) 452-3. 

Hasunuma, T., Nakamura, M., Yachi, T., Arisawa, N., Fukushima, K. and Iijima, H. (2003) The drug-drug interactions of pitavastatin (NK-104), a novel HMG-CoA reductase inhibitor and cyclosporine. Journal of Clinical Therapy Medicine, 19, 381-389. 

Data are also available for MS patients, where supplementation with 25(OH)2D3 increased serum levels of antiinflammatory cytokine TGF-J3 after 6 months of treatment, whereas no or little effect was observed on TNF-a, IL-13, IFN-y and IL-2 [187]. No information was given on the clinical presentation of these patients after treatment. In type I diabetes, a long-term study proved dietary vitamin D supplementation was clinically beneficial in terms of reduced risk of the disease [165]. Heart transplant recipients that were treated with low-dose l,25(OH)2D3 aiming at reduction of bone loss required significantly less cyclosporin for prevention of organ rejection suggesting a potentially beneficial immunosuppressive role of l,25(OH)2D3 in transplantational medicine [188]. 

Medicinal and herbal extracts form the basis for the health care of approximately 80% of the world s population some 21,000 plant species are used world-wide. Screening of natural products led to the discovery of the immunosuppressants, cyclosporin, rapamycin, and FK 506 (153), and there is a continued search for new compounds, even in relatively well-explored areas such as China (154). 

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