ABSTRACT
PURPOSE: To know the body handling properties and anti-proteinuric effect of cyclosporine A(CsA) in children with renal diseases, 34 patients with nephrotic syndrome or glomerular diseases were included to treatment trials and evaluated. METHODS: Microemulsion formula CsA, 5 mg/kg/day was administered orally in two divided doses for 9.3+/-4.6 months. Pharmacokinetic studies of CsA were done twice at beginning and closing of 12 months' CsA therapy. RESULTS: The steady state CsA pharmacokinetic parameters of 34 patients were as follows; Tmax:1.64+/-0.84 hr, Cmax:788+/-354 ng/dL, C12:58.7+/-33.2 ng/mL, Cavg:246+/-96 ng/mL, AUC:2,949+/-1,156 ng hr/mL, Vd:4.03+/-0.45 L/kg, CL:9.69+/-2.27 L/hr, T1/2:5.31+/-2.37 hr. C2 was the best to predict the CsA AUC(R=0.896, P<0.001). Body surface area based dosage(mg/m2/d) correlates best with AUC. Intra-individual CsA pharmacokinetic changes were not found after 12 months' therapy. Anti-proteinuric effect of CsA was considerable; 88.9% of primary nephrotic syndrome and 62.5% of secondary glomerular diseases was responsive to CsA thearpy. There was no serious complication and CsA treatment was well tolerated by the pediatric patients. CONCLUSION: CsA therapy for difficult renal diseases with proteinuria was effective and safe. For better AUC prediction of CsA, body surface area based dosage(mg/m2/d) and C2 monitoring are recommended in children with renal diseases.
Subject(s)
Child , Humans , Area Under Curve , Body Surface Area , Cyclosporine , Nephrotic Syndrome , Pharmacokinetics , ProteinuriaABSTRACT
PURPOSE: Buckwheat is one of the potent allergenic foods, whereas rice is considered as the safest and hypoallergenic food in Korea. However rice can be a causative food allergen, and several report about allergic reactions to rice in Japan. And it is partially true that there is some cross-allergenicity among cereal allergens such as buckwheat, barley, wheat, rice. So, we should consider a false positive reaction to rice during allergic skin tests, especially in cereal allergic patients. We found that a part of buckwheat allergic children showed positive skin reactions to rice antigens, without any allergic reactions after rice ingestion. Therefore the positive skin test results to rice were considered as the false positive reactions due to cross-allergenicity with buckwheat allergen. To evaluate this possibility, we undertook this study. METHODS: To evaluate the cross-allergenicity between rice and buckwheat antigens. With the buckwheat sensitive sera and crude extracts of buckwheat flour and rice flour obtained in Korea, we carried out SDS-PAGE analysis, IgE immunoblot, IgE-immouoblot inhibition test and ELISA inhibition test. RESULTS: Buckwheat extract showed more than 13 antigenic bands and rice extract showed more than 9 bands by SDS-PAGE analysis. IgE immunoblot revealed at least 20 IgE-binding components (ranged 120-4 kDa) with buckwheat extract. IgE-binding capacity of 22 kDa buckwheat component was markedly inhibited by rice extract and 8 kDa component was inhibited slightly. Using IgE ELISA inhibition test, we confirmed buckwheat IgE-ELISA was profoundly inhibited by rice extract, and 50% inhibition was shown in 10-100 ug/ml concentration of rice extract. CONCLUSION: Taken together, the positive reactions to rice antigen would be shown by the result of cross-allergenicity of rice with buckwheat antigen.
Subject(s)
Child , Humans , Allergens , Edible Grain , Complex Mixtures , Eating , Electrophoresis, Polyacrylamide Gel , Enzyme-Linked Immunosorbent Assay , Fagopyrum , False Positive Reactions , Flour , Hordeum , Hypersensitivity , Immunoglobulin E , Japan , Korea , Skin , Skin Tests , TriticumABSTRACT
No abstract available.