Background: In man the immunosuppressive drug Cydosporine A (Cs A) has been used successfully in organ transplantation and in the treatment of autoimmune disorders and exerts toxic effect on various parenchymal organs. This study was performed with the aim of testing whether CYCLOSPORINE plus vitamin A would be reversed the effect of CYCLOSPORINE on rat's testis.Methods and Materials: 40 male Wistar rats, 2 months old were divided into four groups (10 in each group). Experimental groups (A) were injected daily 40 mg/kg body weight of CYCLOSPORINE and olive oil subcutaneously and in group (8) rats were injected daily 40 mg/kg body weight of CYCLOSPORINE and olive oil plus vitamin A. In group (C) rats were injected only olive oil and in group (D) rats were normal and without any injection. Rats were kept under optimal hygienic condition, temperature 25°C, relative humidity 40 to 45% and light provided for a 12-h day/12-h night cycle for 2 weeks. They were given water and rodent pellets.After 2 weeks rats were killed and testis were fixed in formalin 10% and were stained and studied with light microscopy.Results: Distances between seminiferous tubules were increased. Accumulation of necrotic materials of the cells in the lumen of seminiferous, oligospermia, displacement of seminiferous tubules and changing the situation of sertoli nuclei were seen. All of changes were not seen in group (8).Conclusions: we can use vitamin A as a protective in young patient against Cs side effects.

CYCLOSPORINE began to be used as one of the immunosuppressive agents in transplantation in the beginning of the 1980s, and in the treatment of nephrotic syndrome in the pediatric nephrology. Therapeutic area of CYCLOSPORINE is narrow and its side effects limit its usage. Preference for CYCLOSPORINE and tacrolimus as a calcineurin inhibitor is left for the choice of the department. There are still countries with preferred-CYCLOSPORINE use because of economic reasons. CYCLOSPORINE is currently being used in the treatment of nephrotic syndrome, but due to its high relapse rates in a short-term use, and nephrotoxicity in long-term use, search for new drugs with fewer side effects keeps continuing. As long as its use is indispensable, it will be necessary to keep track of kidney function and blood level of this medication closely to protect the patients from toxicity.

Editor, In an interesting paper, Hami and colleagues1 mentioned CYCLOSPORINE trough level (C0) has no direct relation with drug side effects and it is not a suitable measure for assessment of drug side effects. ...

CYCLOSPORINE A (CSA) is currently regarded as one of the common Immunosuppressive agents in organ transplantation among autoimmune patients and GVHD prevention after bone marrow transplantation. It exerts its effects through inhibition of (IL -2, 3, 4) queue expression and IL -2R IFN -r and GM - CSF. The monitoring of CSA is a useful approach to reduce the risk of graft rejection and to prevent its toxicity.This monitoring is performed to obtain optimal doses of CSA peak and exact levels in each patient. To assess the level of CSA in the blood, there are multi-technical methods such as HPLC, RIA, FPIA,... .In this study, CYCLOSPORINE - A (CSA) was conjugated bovine serum albumin (BSA) by glutaraldehyde chemical cross - linker .CSA - BSA conjugate was injected to rabbits and goats subcutaneously in order to obtain CSA specific anti - sera increase in antibody titer was achieved after two times injections.Goat and rabbit sera are detected casein - CSA in a titration of 1: 12000 and 1:8000 respectively. Hyper immune goat and rabbit sera were subjected to caprylic acid precipitation and IgG fraction was conjugated to horse radish peroxidas .These antibodies were able to detect standard levels of CSA (minimum amount =100 mg/ml) in an indirect Elisa assay .The findings suggest these antiserums to be used in the detection of CSA in RBC ,whole blood and patients sera by multi-technical methods, e.g: Immunohistochemistry , immunocytochemistry and Immunofleurescens in future.

Background: CYCLOSPORINE is an immunosuppressive drug used largely in organ graft medicine with serious effects on liver parenchyma. We experienced combination of CYCLOSPORINE and vitamin A for liver damage risk reduction in rats. Materials and Methods: We random allocated 40 rats in 4 study groups and inoculated 1. CYCLOSPORINE with olive oil subcutaneously; 2. intramuscular CYCLOSPORINE and vitamin A; and 3. subcutaneous absolute olive oil. The 4th rat group was not injected and it considered as normal control group. Inoculation was continued for two weeks and rats were kept in standard equal environmental condition. By the end of the injection period they all were dissected and 2 liver tissue samples were studied from each rat using H&E stain and light microscope. Tukey test was used to compare kupfer cells between study groups by considering an alpha level of 0.05 as significant. Results: Hepatocytes disarrangement, congestion and hyperemia of sinusoids, and apoptotic cell enhancement were outcomes of CYCLOSPORINE use in rats. There was also blood in kupfer cells and obscure portal space. In comparison with vitamin A addition CYCLOSPORINE group showed increasing of kupfer cells (P<0.001). Conclusion: Adding Vitamin A to CYCLOSPORINE regimen can probably results in liver damage risk  reduction.      

INTRODUCTION: Aplastic anemia is a potentially fatal hematopoietic disorder. Although its etiology is uncertain, immune dysfunction plays a role in some patients.METHODS: 34 patients with transfusion-dependent, life-threatening aplastic anemia were treated with CYCLOSPORINE-A (CSA) alone or in combination with prednisone after either lack of response to conventional therapy, or immunosuppression with high dose methylprednisolone (6 patients) for 30 to 100 days (median 64 days).RESULTS: CYCLOSPORINE-A was given orally to maintain trough levels of 200-300 ng/ml. In group I, 9 out of 18 patients responded within 50 to 170 days of treatment (median 86 days) and are currently alive 5 years after initiation of therapy with CSA. In group 11, 9 out 16 patients responded within 45 to 160 days of treatment (median 85 days) and are currently alive 5 years after initiation of CSA therapy.DISCUSSION: Our findings indicate that cyclosporin-A can be used in the management of patients with life-threatening bone marrow failure (aplastic anemia) in whom conventional therapy has failed and those who are not candidates for bone marrow transplant for other reasons.

Background: Therapeutic approach to patients with idiopathic membranoproliferative glomerulonephritis is still controversial. Because it is more common in developing countries, the studies about it are limited. Methods: We used CYCLOSPORINE to treat 18 patients with membranoproliferative glomerulonephritis who were resistant to other treatment protocols such as using aspirin, dipyridamole, or steroids. All patients were treated with CYCLOSPORINE plus low-dose prednisone and were followed for an average 108 weeks. Results: Partial or complete remission of proteinuria occurred in 94% of the patients (P<0.01). Relapse occurred in one (14.2%) of remitters after discontinuation of the drug. But the remainder stayed in remission to the end of the observation period. There was a 50% decrease in the baseline creatinine clearance in one patient (5.5%).Conclusion: These results suggest that CYCLOSPORINE may be an effective therapeutic agent in the treatment of resistant idiopathic membranoproliferative glomerulonephritis. Although the response is appeared later than other types of glomerulonephritis, but a long-term decrease in proteinuria and preservation of filtration function were observed in a significant proportion of the treated patients.