Objective:To investigate the effects of diltiazem and cyclosporine A(CsA)combination therapy on protecting the kidney,promoting graft functioning and improving post-transplanted kidney recovery.Methods:The blood concentrations of CsA,the condition of the post-transplant kidney,the rate of acute rejection(AR),as well as hepatic and renal toxicity in 636 cases of renal transplant recipients were determined after being treated by CsA,with or without diltiazem.Results:Compared with the control group which received CsA,mycophenolate mofetil(MMF) and prednisolone(Pred)but lacked diltiazem,the group receiving these agents together with diltiazem required reduced dosage of CsA(P<0.01),while blood concentrations of CsA were significantly increased(P<0.01);the recovery time of graft function was reduced from(6.2±1.5)d to(3.9±1.4)d(P<0.01),and the rate of AR was decreased from 13.2%to 7.9%(P<0.01).Conclusion:In renal transplantation patients treated with CsA and diltiazem,blood concentrations of CsA were increased while the dosage was decreased.This efficient combination therapy reduced patients'economic burden,at the same time retained kidney function,promoted graft function recovery and decreased hepatic and renal toxicity and the rate of AR.
Wujun Xue Yong Song Puxun Tian Xiaoming Ding Xiaoming Pan Hang Yan Jun Hou Xinshun Feng Heli Xiang Xiaohui Tian
Objective: To explore the effects of cytomegalovirus (CMV) infection on rejection-related gene expression in the endothelial cells of renal transplantation recipients. Methods: Endothelial cells (ECs) were cultured and stimulated by a variety of factors: A,normal control group; B,inactivated human cytomegalovirus (HCMV) infection group; C,HCMV infection group; D,HCMV supernatant infection group; and E,ganciclovir HCMV group. Expression of intercellular adhesion molecule-1 (ICAM-1) and major histocompability complex (MHC) class I and class II antigens was detected by flow cytometry (FCM) and immunohistochemistry. Results: We found characteristic CMV-infected ECs in this study. There were no significant differences among groups A,B and D (P>0.05). Although the expression levels of ICAM-1 were not significantly different between groups C and E (P>0.05),the ICAM-1 expression in these two groups was significantly higher than that in group A (P<0.05). ICAM-1 expression was detected in groups C and E,while there was no expression in groups A,B and D. Furthermore,there was no significant difference of ICAM-1 mRNA expression between groups C and E (P>0.05). Human leucocyte antigen (HLA)-ABC expression was detected in all the groups,while HLA-DR expression was only detected in groups C and E. There were no significant differences of HLA-ABC and HLA-DR expression among groups A,B and D (P>0.05). However,the HLA-ABC and HLA-DR expression levels in groups C and D were higher than those of the remaining groups previously reported (P<0.05). Meanwhile,the HLA-ABC and HLA-DR expression levels in group E were lower than those of group C (P<0.05). Conclusion: CMV could up-regulate the expression levels of ICAM-1 and MHC antigens,which was closely related to allograft rejection.
