Abstract
This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.
Highlights
Cyclosporine is a calcineurin inhibitor that acts selectively on T cells
During the follow-up no reactivation or new-onset viral infection was observed [9]. Based on these findings and the available data in the literature, the authors concluded that cyclosporine in monotherapy or in combination with other immunosuppressants is not associated with increased risk of viral infections, and that it may be the treatment of choice in hepatitis C virus (HCV)-positive patients, who require immunosuppressive therapy
It was achieved independently from the cyclophilin pathway that was mentioned earlier as a potential antiviral point of reference for cyclosporine [12]. These data pointing to the possible beneficial effect of cyclosporine on Hepatitis D virus (HDV) infection have to be interpreted in the context of animal model data from many years ago, which indicated that treatment with cyclosporine may increase viraemia, and that upon discontinuation of treatment, HDV-RNA levels either return to pretreatment levels or became negative
Summary
Cyclosporine is a calcineurin inhibitor that acts selectively on T cells. It was isolated from Tolypocladium inflatum fungi in 1970, and it is widely used as an immunosuppressive drug [1,2] in such areas of medicine as dermatology, transplantology, nephrology, rheumatology and ophthalmology. An increased risk of infections is believed to be an adverse effect of cyclosporine. During the COVID-19 pandemic, concerns are being raised about the safety of patients treated with cyclosporine. It has Biology 2020, 9, 192; doi:10.3390/biology9080192 www.mdpi.com/journal/biology. Biology 2020, 9, An increased risk of infections is believed to be an adverse effect of cyclosporine. 19 pandemic, concerns are beingmay raised about safety of patientswith treated cyclosporine. Been debated whether cyclosporine may have an effect on infection with the SARS-CoV2 Searches were performed to identify their articles variations), including specific names of infectious diseases.
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