Difference of Cyclosporin A and Endothelin-1 Concentrations between a Patient with Hypertension and without Hypertension after Allogeneic Bone Marrow Transplantation

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Background. Cyclosporin-induced hypertension is considered to be a result of elevated plasma endothelin-1 (ET-1) oo sodium retention. Methods. To evaluate the function and the degree of vascular damage of endothelial cells in cyclosporininduced hypertension after allogeneic bone marrow transplantation (BMT), we continuously measured blood pressure by ambulatory blood pressure monitoring and measured plasma levels of endothelin-1 and soluble thrombomodulin (TM) together with cyclosporin A (CsA) concentration. Results. CsA level was the lowest one hour after the administration of CsA and peaked 4-6 hours after it. ET-1 levels had a similar profile to CsA levels. No change in TM levels was observed. Systolic blood pressure levels were over 140 mmHg throughout the day, and tended to rise further degree 3-4 hours after the ET-1 level rose. The presence of an immediate change in systolic blood pressure associated with ET-1 change was unclear. In contrast, another patient who had normal ET-1 levels and low concentration levels of CsA showed normal blood pressure. Conclusions. ET-1 is released from endothelial cells, probably due to cyclosporin, and may contribute to cyclosporin-induced hypertension after BMT.
新潟大学の論文