Details

Autor(en) / Beteiligte

• Joannidès, R.
• Monteil, C.
• de Ligny, B. H.
• Westeel, P. F.
• Iacob, M.
• Thervet, E.
• Barbier, S.
• Bellien, J.
• Lebranchu, Y.
• Seguin, S. G.
• Thuillez, C.
• Godin, M.
• Etienne, I.

Titel

Immunosuppressant Regimen Based on Sirolimus Decreases Aortic Stiffness in Renal Transplant Recipients in Comparison to Cyclosporine

Ist Teil von

• American journal of transplantation, 2011-11, Vol.11 (11), p.2414-2422

Ort / Verlag

Malden, USA: Blackwell Publishing Inc

Erscheinungsjahr

2011

Quelle

Wiley Online Library All Journals

Beschreibungen/Notizen

• Whether or not a cyclosporine A (CsA)‐free immunosuppressant regimen based on sirolimus (SRL) prevents aortic stiffening and improves central hemodynamics in renal recipients remains unknown. Forty‐four patients (48 ± 2 years) enrolled in the CONCEPT trial were randomized at week 12 (W12) to continue CsA or switch to SRL, both associated with mycophenolate mofetil. Carotid systolic blood pressure (cSBP), pulse pressure (cPP), central pressure wave reflection (augmentation index, AIx) and carotid‐to‐femoral pulse‐wave velocity (PWV: aortic stiffness) were blindly assessed at W12, W26 and W52 together with plasma endothelin‐1 (ET‐1), thiobarbituric acid‐reactive substances (TBARS) and superoxide dismutase (SOD) and catalase erythrocyte activities. At W12, there was no difference between groups. At follow‐up, PWV, cSBP, cPP and AIx were lower in the SRL group. The difference in PWV remained significant after adjustment for blood pressure and eGFR. In parallel, ET‐1 decreased in the SRL group, while TBARS, SOD and catalase erythrocyte activities increased in both groups but to a lesser extent in the SRL group. Our results demonstrate that a CsA‐free regimen based on SRL reduces aortic stiffness, plasma endothelin‐1 and oxidative stress in renal recipients suggesting a protective effect on the arterial wall that may be translated into cardiovascular risk reduction. The authors show that, in addition to reduced plasma endothelin‐1 and oxidative stress, a cyclosporine‐free immunosuppressant regimen based on sirolimus prevents aortic stiffening and improves central hemodynamics in renal recipients, vascular effects which may translate into cardiovascular risk reduction.