Document Detail

Immunosuppressant regimen based on sirolimus decreases aortic stiffness in renal transplant recipients in comparison to cyclosporine.
MedLine Citation:
PMID:  21929645     Owner:  NLM     Status:  MEDLINE    
Whether or not a cyclosporine A (CsA)-free immunosuppressant regimen based on sirolimus (SRL) prevents aortic stiffening and improves central hemodynamics in renal recipients remains unknown. Forty-four patients (48 ± 2 years) enrolled in the CONCEPT trial were randomized at week 12 (W12) to continue CsA or switch to SRL, both associated with mycophenolate mofetil. Carotid systolic blood pressure (cSBP), pulse pressure (cPP), central pressure wave reflection (augmentation index, AIx) and carotid-to-femoral pulse-wave velocity (PWV: aortic stiffness) were blindly assessed at W12, W26 and W52 together with plasma endothelin-1 (ET-1), thiobarbituric acid-reactive substances (TBARS) and superoxide dismutase (SOD) and catalase erythrocyte activities. At W12, there was no difference between groups. At follow-up, PWV, cSBP, cPP and AIx were lower in the SRL group. The difference in PWV remained significant after adjustment for blood pressure and eGFR. In parallel, ET-1 decreased in the SRL group, while TBARS, SOD and catalase erythrocyte activities increased in both groups but to a lesser extent in the SRL group. Our results demonstrate that a CsA-free regimen based on SRL reduces aortic stiffness, plasma endothelin-1 and oxidative stress in renal recipients suggesting a protective effect on the arterial wall that may be translated into cardiovascular risk reduction.
R Joannidès; C Monteil; B H de Ligny; P F Westeel; M Iacob; E Thervet; S Barbier; J Bellien; Y Lebranchu; S G Seguin; C Thuillez; M Godin; I Etienne
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-09-19
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  11     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-27     Completed Date:  2012-02-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2414-22     Citation Subset:  IM    
Copyright Information:
©2011 The Authors Journal compilation © 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
Department of Pharmacology, Rouen University Hospital, University of Rouen, Rouen, France.
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MeSH Terms
Blood Pressure / drug effects
Cyclosporine / adverse effects
Endothelin-1 / blood
Immunosuppressive Agents / therapeutic use*
Kidney Transplantation / methods*
Middle Aged
Mycophenolic Acid / analogs & derivatives,  therapeutic use
Sirolimus / therapeutic use*
Vascular Stiffness / drug effects*
Reg. No./Substance:
0/Endothelin-1; 0/Immunosuppressive Agents; 24280-93-1/Mycophenolic Acid; 53123-88-9/Sirolimus; 59865-13-3/Cyclosporine; 9242ECW6R0/mycophenolate mofetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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