Current methods of the analysis of immunosuppressive agents in clinical materials : a review

Adriana Mika , Piotr Stepnowski

Abstract

More than 100 000 solid organ transplantations are performed every year worldwide. Calcineurin (cyclosporine A, tacrolimus), serine/threonine kinase (sirolimus, everolimus) and inosine monophosphate dehydrogenase inhibitor (mycophenolate mofetil), are the most common drugs used as immunosuppressive agents after solid organ transplantation. Immunosuppressive therapy, although necessary after transplantation, is associated with many adverse consequences, including the formation of secondary metabolites of drugs and the induction of their side effects. Calcineurin inhibitors are associated with nephrotoxicity, cardiotoxicity and neurotoxicity; moreover, they increase the risk of many diseases after transplantation. The review presents a study of the movement of drugs in the body, including the processes of absorption, distribution, localisation in tissues, biotransformation and excretion, and also their accompanying side effects. Therefore, there is a necessity to monitor immunosuppressants, especially because these drugs are characterised by narrow therapeutic ranges. Their incorrect concentrations in a patient’s blood could result in transplant rejection or in the accumulation of toxic effects. Immunosuppressive pharmaceuticals are macrolide lactones, peptides, and high molecular weight molecules that can be metabolised to several metabolites. Therefore the two main analytical methods used for their determination are high performance liquid chromatography with various detection methods and immunoassay methods. Despite the rapid development of new analytical methods of analysing immunosuppressive agents, the application of the latest generation of detectors and increasing sensitivity of such methods, there is still a great demand for the development of highly selective, sensitive, specific, rapid and relatively simple methods of immunosuppressive drugs analysis.
Author Adriana Mika PChZŚ
Adriana Mika,,
- Laboratory of Chemical Environmental Risks
, Piotr Stepnowski PChZŚ
Piotr Stepnowski,,
- Laboratory of Chemical Environmental Risks
Journal seriesJournal of Pharmaceutical and Biomedical Analysis, ISSN 0731-7085
Issue year2016
Vol127
Pages207-231
Publication size in sheets1.2
Keywords in Englishimmunosuppresive drugs, immunoassays, LC–MS/MS methods, mass spectrometry, therapeutic drug monitoring, transplant rejection
DOIDOI:10.1016/j.jpba.2016.01.059
URL http://dx.doi.org/10.1016/j.jpba.2016.01.059
Languageen angielski
Score (nominal)35
ScoreMinisterial score = 35.0, 20-12-2017, ArticleFromJournal
Ministerial score (2013-2016) = 35.0, 20-12-2017, ArticleFromJournal
Publication indicators WoS Impact Factor: 2016 = 3.255 (2) - 2016=2.953 (5)
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