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Pharmacokinetic and pharmacodynamic monitoring of immunosuppressive therapy
Individualized immunosuppression
Optimization of calcineurin inhibitor-containing immunosuppression with the help of NFAT-regulated gene expression.
To date, the daily dose of cyclosporine A (CsA) or tacrolimus (Tac) has been adjusted on the basis of CsA or Tac serum levels as trough levels or 2h levels.
Pharmacodynamic monitoring with determination of the inhibition of relevant cytokines such as interleukin 2, interferon and GM-CSF represents an option for optimizing individualized immunosuppression.
In a collective of long-term transplant patients, there was evidence of the superiority of pharmacodynamically controlled CsA dosing compared to adjustment according to CsA serum levels with regard to malignancy risk and recurrent infections. A gradual reduction of the ciclosporin dose in long-term transplant patients under control of NFAT-regulated gene expression appears to be safe up to a certain cut-off and reduces CsA-induced side effects; this form of pharmacodynamic monitoring is currently being evaluated in several projects.
Project management
Prof. Dr. med. Claudia Sommerer
claudia.sommerer@med.uni-heidelberg.de
+49 6221 9112 0
Persons involved
Cand. med. Theresa Klein
Prof. Dr. Martin Zeier
Partner
PD Dr. Thomas Giese, Immunology Heidelberg
Prof. Dr. Meuer, Immunology Heidelberg