シクロスポリン療法の血脂タンパク質濃度に対する効果
C M Ballantyne1, E J Podet, W P Patsch
1Section of Atherosclerosis, Baylor College of Medicine, Houston, Tex.
JAMA
|July 7, 1989
まとめ
シクロスポリン薬は,総コレステロールと低密度リポプロテインコレステロールのレベルを大幅に上昇させます. この発見は,シクロスポリン治療を受けている患者の脂質プロフィールの管理に極めて重要です.
科学分野:
- 心臓病学 心臓病学
- ネフロロジーはネフロロジーを用います.
- 薬理学 薬理学とは
背景:
- 加速性動脈硬化症は,移植後の生存者の死亡の主な原因である.
- 移植後の高脂血症は頻繁に発生し,代謝と栄養の評価を複雑にします.
- 免疫抑制剤と抗高血圧剤を含む薬物効果は,移植受容者における高脂血症のメカニズムを混乱させる.
研究 の 目的:
- 脂質レベルに対するサイクロスポリンの特定の影響を隔離し,決定する.
- シクロスポリン単独療法がプラズマリポプロテインプロファイルに悪影響を及ぼすかどうかを調査する.
主な方法:
- 予見性,ダブルブラインド,ランダム化,プラセボ対照試験が行われました.
- アミオトロフィック横筋硬化症の36人の男性は,サイクロスポリンまたはプラセボを投与されました.
- 血脂質とアポリポプロテインのレベルは,ベースラインとフォローアップの間隔 (2週間,1ヶ月,2ヶ月) で測定されました.
主要な成果:
- サイクロスポリン群では,総コレステロールの21%,低密度リポプロテイン (LDL) コレステロールの31%,アポリポプロテインBの12%が著しく増加しました.
- プラセボ群では有意な変化は見られなかった.
- シクロスポリン単独治療は,プラズマのリポプロテインレベルに有害な影響と関連していました.
結論:
- サイクロスポリン療法は,主にLDLコレステロールを増加させることで,総コレステロールを著しく上昇させます.
- この効果は,サイクロスポリンで治療された患者におけるアテロスクレロスの加速の潜在的なメカニズムを強調しています.
- シクロスポリンを投与している患者には,脂質プロフィールの注意深いモニタリングが必要である.
関連する概念動画
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion
Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...


