• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.202-206
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• 2008

An 8-year-old, castrated male Shih-tzu was referred due to relapsing pododermatitis and generalized pruritus. On physical examination, right forepaw showed swelling and serosanguinous exudates from sinus tract on dorsal paw. There were no remarkable findings on complete blood count (CBC), serum chemistry, and radiologic examination. On cytological examination of exudates from sinus tract, phagocyted bacteria and numerous degenerative neutrophils were noted. Results of deep skin scraping and plucking hair examination were unremarkable. Skin biopsy was performed and ruled out other skin diseases. Histopathology showed epidermal hyperplasia and diffuse mononuclear cell inflammation in dermal layer. Moreover, pyogranulomatous inflammation was demonstrated in subcutaneous layer. This case was clinically diagnosed as pododermatitis secondary to atopic dermatitis (AD). Clinical signs of pododermatitis were gradually improved following topical application of tacrolimus 0.1% ointment. This case report describes that tacrolimus ointment can be applicable for the treatment of refractory pododermatitis.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.195-197
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• 2017

A 74-year-old man suffering from cryptogenic organizing pneumonia (OP) visited our department with arthralgia accompanied with partial swellings of proximal interphalangeal and metacarpophalangeal joints with morning stiffness. A diagnose of rheumatoid arthritis (RA) was made. It was thought that OP was associated with RA. We initiated a treatment with salazosulfapyridine and loxoprofen for RA. Although this treatment was effective, it was discontinued due to the development of drug eruption. As an alternative, the patient was treated with prednisolone (PSL) and clarithromycin (CAM). This treatment demonstrated being effective for OP and RA, to a certain extent; however, the RA activity was not completely suppressed. In order to suppress the RA activity further, tacrolimus (TAC) was successfully added with increasing the dosage of CAM that is assumed to raise blood TAC concentrations. The present case shows that treatment with PSL, CAM and TAC may be effective in some cases of RA.

• Journal of Oral Medicine and Pain
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• v.43 no.1
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• pp.16-20
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• 2018

Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.476-480
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• 2005

Immunosuppressive therapy in pediatric renal transplant recipients is changing consequence of the increasing number of available immunosuppressive agents. The optimal use of immunosuppressive agents requires a thorough understanding of the pharmacokinetic characteristics, but the information on the pharmacokinetic characteristics of these drugs in pediatric transplant recipients is still limited. In general, patients younger than 5 years old show higher clearance rates, therefore the need for higher dosages in younger patients seems evident. By the therapeutic drug monitoring, trough($C_{min}$) and peak level($C_{max}$) are measured and the area under the blood concentration-time curve(AUC), which is taken as being representative of total systemic exposure can be calculated. Cyclosporine A (CSA) has poor bioavailability, which contributes to high inter- and intra-patient pharmacokinetic variability. CSA concentration measured 2 hours after administration($C_2$) has better correlation with the AUC than $C_{min}$ and is an alternative technique that predicts the AUC. Tacrolimus(Tac) has a great deal of inter-individual variability like CSA but intra-individual variability in systemic exposure is considered to be low. Both CSA and Tac are metabolized by a cytochrome P-450 enzyme isoform(CYP3A4). We should consider changing the dosages when CSA or Tac is used in combination with the medicines that inhibit or induce the CYP3A4. In case of steroid-free immunosuppressive therapy, the blood concentration of Tac should be frequently checked and dosage adjustment may be needed.

• Proceedings of the Microbiological Society of Korea Conference
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• 2006.05a
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• pp.108-110
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• 2006

• Korean Journal of Clinical Pharmacy
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• v.8 no.1
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• pp.68-73
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• 1998

• Journal of Korean Dental Science
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• v.5 no.1
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• pp.1-6
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• 2012

Patients with gingival overgrowth are easily seen in dental clinics. Cyclosporin-A (CsA), a widely prescribed immunosuppressant induces gingival overgrowth in up to 35% of patients with medical history of organ transplantation. The immunosuppressant CsA can transform genetic expression of gingival fibroblasts, resulting in gingival overgrowth. Meticulous plaque control is recommended for treatment of gingival overgrowth. Substitution of the drug or surgical procedures such as gingivectomy and periodontal flaps should be considered after re-evaluation. Azithromycin is often recommended as a supplementary drug to reduce this side effect. Recent studies show that tacrolimus can be a more economic, efficient and safe substitute for CsA.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.306.2-306.2
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• 2002

The main targets for the immunosuppressive calcineurin inhibitors. tacrolimus (FK-506) and cyclosporine A (CsA). have been considered to be activated T cells. but not antigen presenting cells (APCs). In the present study. we examined the effects of these drugs on the MHC-restricted presentation of exogenously added antigen. ovalbumin (OVA). in dendritic cells (DCs). Particulate form of OVA was efficiently captured. processed and presented on class I MHC molecules (cross-presentation) as well as on class II MHC molecules. (omitted)

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.11-21
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• 2012

New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. The purpose of this study is to develop novel immune suppressants for PTDM using of action mechanism of them. The use of immunosuppressive drugs in transplanted patients is associated with the development of diabetes, possibly due to ${\beta}$-cell toxicity. To better understand the mechanisms leading to post-transplant diabetes, we investigated the actions of prolonged exposure of ${\beta}$-cells to therapeutical levels of tacrolimus (FK506) or cyclosporin A(CsA). The immunosuppressive drug cyclosporine(CsA) is a potent agent widely used after organ transplantations and various autoimmune disorders. After using CsA, some patients suffer severe complications including renal and vascular toxicity. The renal or vascular toxicity is influenced by the degree of the endothelial damage. FK506(tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. We found some interesting clusters and confirmed the feasibility of cDNA microarray in the study of Immunosuppressant. In this study, we investigated gene expression patterns induced by Immunosuppressant in RIN-m5F of rat insulinoma cell line. Gene expressions evaluated using cDNA microarry in two clusters were increased or decreased. this study provides comprehensive comparison of the patterns of gene expression changes induced by CsA and FK506 in ${\beta}$-cells. This study could establish that the mode of action mechanism by which currently used insulin inhibitors inducing PTDM could be elucidated at least in part, which raises the possibility that novel immune suppressive PTDM can be developed. The molecular biological study on PTDM will also contribute the progress in diabetes research field as well as in that of PTDM.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.746-750
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• 2010

Three military working dogs (MWDs) were diagnosed with perianal fistulae after a complete physical examination and rectal palpation. The initial treatment protocol was used with short-term oral ciclosporine (CyA) and ketoconazole and 0.1% topical tacrolimus ointment. When lesions were nearly healed, treatment was continued with 0.1% tacrolimus ointment only at a lower frequency. The lesions improved significantly within 2-8 weeks with no noticeable side effects. Complete recovery was determined at weeks 13, 6, and 4 for cases 1, 2, and 3, respectively. This combination protocol was effective at resolving or reducing perianal fistulae (PAF) lesions even communicating with anal sacs in three dogs. The major benefit of this protocol was the rapid reduction of fistulae lesions and this could be helpful to extend the pain-free period. Moreover, this protocol appeared cost-saving as well as time-saving option for PAF dogs.