A prospective analysis of the effects of enteric-coated mycophenolate sodium and mycophenolate mofetil co-medicated with a proton pump inhibitor in kidney transplant recipients at a single institute in China.

BACKGROUND: Enteric-coated mycophenolate sodium (EC-MPS) and mycophenolate mofetil (MMF), two prodrugs of mycophenolic acid (MPA), have been used in immunosuppressive regimens. After being taken orally, both of them transform to MPA to achieve immune suppression effects; however, the main site of absorption and metabolism of EC-MPS is different from that of MMF in vivo. Therefore, combined application with related drugs may result in different MPA levels and have different clinical effects in kidney transplant recipients. OBJECTIVE: To evaluate the efficacy of EC-MPS compared with MMF in Chinese renal transplant patients comedicated with a proton pump inhibitor (PPI). METHODS: Our subjects were 88 patients who received renal transplants at the 309th Hospital of the Chinese PLA from May 2010 to April 2013. These were made up of two groups including 27 patients with EC-MPS and 61 with MMF. The immunosuppression regimen was EC-MPS/MMF + cyclosporine/tacrolimus + steroid hormone, comedicated with a PPI (omeprazole). The patients' levels of exposure of MPA within 1 week after operation were monitored. Clinical indicators such as incidence of delayed graft function and acute rejection, the rate of change of serum creatinine hemoglobin, leucocytes, and neutrophils, as well as clinical adverse drug reactions and drug conversion were analyzed retrospectively. RESULTS AND CONCLUSION: The kidney function of patients recovered to normal in both the EC-MPS and MMF groups. The mean concentration to peak (Cmax), the mean half-life (t1/2), and the area under the concentration-time curve (AUC0-12) of MPA in the EC-MPS group were higher than those in the MMF group (P < .05). This indicated that the pharmacokinetic parameters for MPA when EC-MPS is co-administered with a PPI in kidney transplant patients in China is better than for comedication with MMF and a PPI. The MMF group had a higher incidence of drug withdrawal because of higher infection rates, leucocyte decrease, and more gastrointestinal side effects than the EC-MPS group (P < .05). No significant differences in the clinical effect on kidney transplant recipients were observed in the limited observation time.

Russula cutefracta inhibits antigen-induced degranulation and Syk and MAPK phosphorylation in rat basophilic leukaemia cells

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Clinical relevance of sHLA-G-mediated with better graft acceptance in early posttransplantation.

The aim of this study was to measure the level of soluble human leukocyte antigen (sHLA-G) in renal transplant patients, to determine the relationship between these levels and the occurrence of acute rejection episodes, and to identify their influence on graft acceptance early posttransplantation. sHLA-G, as measured by an enzyme-linked immunosorbent assay, was significantly increased (P < .01) early posttransplantation (3 months); the other group maintained low levels throughout the study. The latter group displayed a high incidence of acute rejection episodes and a lower clearance of serum creatinine with a longer period for hemoglobin to recover to normal (P < .01). These results suggested that HLA-G participates in the induction of immunologic tolerance in these recipients.