Cyclosporin A is a hormonal immunomodulator. I. Human study

Area of Science:

• Endocrinology
• Immunology
• Nephrology

Background:

• Long-term Cyclosporin A (CS) use is associated with hormonal disorders: gynecomastia in males and hirsutism in females.
• The relationship between CS's steroid-mimetic actions and its immunosuppressive effects requires investigation.

Purpose of the Study:

• To investigate if the steroid-mimetic actions of Cyclosporin A are linked to its immunosuppressive effects.
• To compare urinary steroid excretion and transplant success rates between CS-free and CS-dependent immunosuppressive treatments.

Main Methods:

• A case-control study comparing 14 urinary steroid excretions in males and females.
• Included healthy controls and kidney transplant recipients on CS-free and CS-dependent immunosuppression.
• Compared kidney transplant success rates between treatment groups.

Main Results:

• Both CS-free and CS-dependent treatments generally depressed urinary androgens, progestins, and corticosteroids.
• The suppressive effect was more pronounced with CS-dependent treatment.
• CS-free treatment intactly excreted tetrahydrocortisol (THF) in males but depressed it in females.
• CS-free treatment significantly depressed the urinary androsterone (AD) to THF ratio (androgen to glucocorticoid balance) in both sexes.

Conclusions:

• Cyclosporin A treatment impacts urinary steroid excretion, affecting androgen and corticosteroid balance.
• The observed hormonal changes may be related to Cyclosporin A's immunosuppressive mechanism.
• Further studies are warranted to fully elucidate the endocrine side effects of Cyclosporin A.