CYCLOSPORINE IN AUTOIMMUNE-DISEASES

At a symposium held in Zurich in November 1993, a series of presentati ons covered the optimal use of cyclosporin A (CsA) in autoimmune disea ses. Besides its immunosuppressive effects in organ transplantation, C sA appears to be active in a variety of autoimmune disorders. Its most pronounced and beneficial clinical effects are seen in patients with severe rheumatoid arthritis. New clinical studies include the nephroti c syndrome in children and patients with systemic lupus erythematodes. The main concern remains CsA induced nephrotoxicity. For the treatmen t of autoimmune disorders CsA can be used at lower doses (less than or equal to 5 mg/kg per day) than in transplantation medicine. Thus, mon itoring of CsA blood concentrations is not usually necessary. The gale nics of CsA has been optimized recently, an achievement which will fur ther improve the clinical use of CsA. Due to increased knowledge of in tracellular CsA binding proteins and of effects of CsA on T-lymphocyte s and cytokine production, it can be expected that novel immunsuppress ive compounds will be developed.