Modification of c and n sources for enhanced production of cyclosporin 'a' by Aspergillus Terreus

Most of the studies regarding cyclosporin 'A' production through fungi concentrate around Tolypocladium inflatum. This is mainly due to lower reported production of this drug in other fungi. The present study was therefore conducted to explore indigenous isolates of Aspergillus terreus for synthesis of this drug and defining a production medium for obtaining high yield of cyclosporin 'A'. For this purpose carbon and nitrogen sources were optimized for the selected best strain of A. terreus. Overall results depicted that the best cyclosporin 'A' yield from selected Aspergillus terreus (FCBP58) could be obtained by using production medium containing glucose 10 percent as carbon source and peptone 0.5 percent as nitrogen source. This modification in production medium enhanced drug synthesis by selected fungi significantly. The production capabilities when compared with biomass of fungi there was found no relationship between the two confirming that the medium modification increased overall drug synthesis powers of the fungi.

Síndrome de dor óssea induzida por tacrolimo pós-transplante renal: relato de caso e revisão da literatura / Tacrolimus induced bone pain syndrome after kidney transplantation: case report and review of the literature

Objetivo: Relatar um caso de síndrome de dor óssea induzida por inibidores da calcineurina. Relato de caso: Paciente masculino de 54 anos, branco, foi que submetido a transplante renal haploidêntico e, ao fim do terceiro mês pós-transplante, apresentou dor espontânea, de forte intensidade, em joelhos, tornozelos e pés, de maneira simétrica, com incapacidade funcional, induzida por inibidores da calcineurina. O diagnóstico foi comprovado por ressonância magnética e cintilografia óssea. Evolução: Houve remissão espontânea e completa dos sintomas no fim do sexto mês após o transplante. Conclusão: A síndrome de dor osteoarticular induzida por inibidores da calcineurina é uma condição clínica incomum, mas que pode comprometer a qualidade de vida e a boa evolução do paciente transplantado. Seu diagnóstico correto deve ser feito prontamente por meio de estudos de ressonância magnética e de cintilografia óssea.

Objective: To present a case of calcineurin inhibitor-induced bone pain syndrome. Case report: A 54-year-old Caucasian male patient underwent a haploidentical kidney transplant and, at the end of the third postoperative month, developed severe, spontaneous, symmetrical pain in his knees, ankles, and feet, associated with functional impairment, induced by calcineurin inhibitors. The diagnosis was confirmed by MRI and bone scan. Evolution: The patient presented spontaneous remission of symptoms at the end of the sixth postoperative month. Conclusion: Calcineurin inhibitorinduced bone pain syndrome is an uncommon clinical condition, but it can impair the quality of life and good evolution of transplant recipients. Correct and prompt diagnosis with MRI and bone scan is recommended.

[ relationship between the plasma level of cyclosporine-A and drug dose in patients of Kermanshah Kidney Transplantation Center]

Nowadays the main problem in transplantation is the complexity of host immune system protection against the immunological and destructive reactions of the transplanted organ. High serum level of the immunosuppressive drug may cause toxicity and low serum level leads to the rejection of the transplanted organ. Cyclosporine has been known as the most effective immunosuppressive drug. Our goal in this study was to determine the relationship between cyclosporine serum level and administered dose in renal transplant recipients in order to find the optimum cyclosporine dose in Kermanshah kidney transplantation center. This descriptive-analytical study with simple sampling was done on 80 renal transplant recipients [51 males and 29 females] in Kermanshah transplantation center. At least 6 months after transplantation, in patients with stable conditions, cyclosporine peak and trough levels were measured by specific monoclonal, Radio Immuno Assay [RIA] method over a period of 3 months. Other biochemical parameters were measured too. Data were analyzed by 2 and ANOVA tests. Mean cyclosporine Trough and Peak levels were 271.9 +/- 85.2 and 904.5 +/- 414.2 ng/ml respectively, for the treatment dose of 3.25 +/- 1.46 mg/kg B.W. There was no significant difference between trough and peak levels in all three administered doses and the range of administered dose was 1.79-4.71 mg/kg B.W. According to the findings, cyclosporine serum concentrations and the administered dose range differed from other studies. This may be due to pharmacologic and pharmacokinetic differences of the drug and individual physiological characteristics of patients. The minimum dose of 1.79 and maximum dose of 4.71 led to optimum treatment in stable patients and could prevent rejection or toxic effects. Cyclosporine peak level was obviously different from other studies; however it showed better relationship with clinical status. Conversion from the routine cyclosporine C[trough] monitoring to C[peak] monitoring is recommended in Kermanshah kidney transplantation center