Original ArticleMonitoring of Nuclear Factor of Activated T-Cell-Regulated Gene Expression in De Novo and Long-Term Liver Transplant Recipients Treated With Cyclosporine AHerden, Uta MD*; Kromminga, Arno PhD†*; Hagel, Christine†; Hartleb, Jürgen PhD†; Nashan, Björn MD FACS FRCSC*; Sterneck, Martina MD*; Fischer, Lutz MD*Author Information From the *Department of Hepatobiliary Surgery and Solid Organ Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and †Labor Lademannbogen, Lademannbogen 61, Hamburg, Germany. Received for publication August 1, 2010; accepted January 18, 2010. U.H. and A.K. contributed equally to this work. There are no conflicts of interest to declare for any author. There are no grants or other additional financial support. Correspondence: Uta Herden, MD, Department of Hepatobiliary Surgery and Visceral Transplantation, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany (e-mail: [email protected]). Therapeutic Drug Monitoring: April 2011 - Volume 33 - Issue 2 - p 185-191 doi: 10.1097/FTD.0b013e318210e6d0 Buy Metrics Abstract Pharmacodynamic drug monitoring might allow an improved use of immunosuppressive medication in transplant recipients. We assessed whether drug concentrations reflect the effect of cyclosporine (CsA) on expression of nuclear factor of activated T-cells-regulated cytokines. CsA drug concentrations and expression of interleukin-2, interferon-γ, and granulocyte-macrophage colony-stimulating factor in stimulated blood lymphocytes were determined predose (C0) and 2 hours after (C2) CsA intake in 20 de novo (less than 3 months) and 20 long-term (3 months to 10 years) liver transplant patients. The residual cytokine expression at C2 relative to C0 was calculated. Mean CsA C0 and C2 concentrations were 236 and 776 μg/L in de novo and 100 and 573 μg/L in long-term liver transplant patients, respectively. Two hours after CsA intake, the residual cytokine expression for all cytokines was comparable in both groups (de novo patients mean 16%; long-term patients mean 17%). CsA C2 concentrations showed a significant (P < 0.01) correlation with the residual cytokine expression of interleukin-2, interferon-γ, and granulocyte-macrophage colony-stimulating factor in both de novo and long-term patients, whereas CsA C0 concentrations did not. The data suggest that CsA C2 concentrations, but not C0 concentrations, reflect the effect of CsA on downregulation of cytokine expression in both de novo and long-term liver transplant patients. © 2011 Lippincott Williams & Wilkins, Inc.