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cyclosporin A in blood

Indications: - therapeutic drug monitoring, cyclosporine A - organ transplantation - rheumatoid arthritis - inflammatory bowel disease - *severe asthma Reference values: - trough < 300 ng/mL - renal tranplantation (trough) [3] - 200-300 ng/mL (1st few weeks) - 50-75 ng/mL (after 3 months) Clinical significance: Cyclosporine may be administered IV or orally. Absorption from the gastrointestinal tract is variable, unpredictable & incomplete. Bio-availability increases during treatment so that oral doses must be gradually reduced in order to maintain a constant cyclosporine concentration is the blood. Cyclosporine is almost completely metabolized in the liver by cyt P-450 3A4. 10-20 metabolites have been identified; several of these have been found in the whole blood. It is not clear whether the nephrotoxicity of cyclosporine is the result of toxic levels of the parent drug, or of the metabolites, or combination of both. A number of drugs affect the blood concentration of cyclosporine. Inducers of cyt P-450 3A4, including phenytoin, phenobarbital & rifampin, are reported to increase cyclosporine blood concentrations, presumably through increased metabolism; erythromycin increases blood concentration by inhibiting clearance. The use of cyclosporine is associated with serious toxic side effects, primarily nephrotoxicity & hepatotoxicity. Other adverse effects include diarrhea, gum hyperplasia, nausea, vomiting, hirsutism, tremor & hypertension. Principle: The ABBOTT TDx Cyclosporine Monoclonal Antibody Whole Blood assay is an -in vitro- reagent system for the quantitative measurement of cyclosporine (Sandimmune Cyclosporine A) in human whole blood samples. The TDx Cyclosporine Monoclonal Whole Blood assay utilizes Fluorescence Polarization Technology. The antigen in the specimen competes with the antigen-tracer in the reagent for binding sites in the antibody. When the amount of antigen in the unknown specimen is high, more antigen will bind to the antibody leaving the antigen-tracer free in solution, i.e., small molecules rotating rapidly. When the amount of antigen in the specimen is low, less will bind to the antibody, & more antigen-tracer will bind, i.e., large molecule rotating slowly. Specimen: 1) Whole Blood specimens (EDTA) are used in this assay. 2) The specimens should be kept at room temperature. SAMPLE VOLUME: 150 uL of specimen is the minimum volume required.

Related

cyclosporin A (Sandimmune, Neoral [CsA])

Specific

cyclosporin A in blood 1 hour post dose cyclosporin A in blood 2 hours post dose cyclosporin A in blood 3 hours post dose cyclosporin A in blood 4 hours post dose cyclosporin A in blood by immunoassay cyclosporin A in blood by LC/MS/MS cyclosporin A in blood peak cyclosporin A in blood trough cyclosporin A in dried blood spot

General

cyclosporin A in body fluid therapeutic drug measurement

References

  1. Abbott Laboratories,Diagnostic Division ,Abbott Park, IL 60064 Cyclosporine Monoclonal Whole Blood, April, 1985.
  2. Borel JF. Cyclosporin-A - present experimental status. Transplant Proc. 1981; 13: 344-8.
  3. Interpretation of Diagnostic tests, 8th edition, Wallach J, Lippincott, Williams & Wilkens, Philadelphia, 2007
  4. Cyclosporine A Laboratory Test Directory ARUP: 70035