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The effect of ciclosporin on the cellular immunoregulation was examined in 19 patients with IgA nephropathy. The patients were randomly divided into two groups: 9 patients receiving oral ciclosporin (5 mg/kg/day) for 12 weeks and 10 patients receiving placebo and acting as controls. T lymphocyte subpopulations were determined using OKT monoclonal antibodies. The functional capability of lymphocytes was assessed by in vitro immunoglobulin synthesis of cultured peripheral mononuclear cells, thymidine uptake by cultured lymphocytes, and t lymphocyte activation with expression of interleukin-2 receptors. A fall of in vitro IgA production by cultured lymphocytes (p less than 0.05), a reduction of thymidine uptake by Staphylococcus aureus Cowan-stimulated cultured lymphocytes (p less than 0.05), and a reduction of activated lymphocytes expressing interleukin-2 receptor (p less than 0.05) were observed in patients after 12 weeks of ciclosporin therapy. The percentages of OKT4 and OKT8 lymphocytes and OKT4/8 ratios were not altered with therapy. A simultaneous reduction of proteinuria and a transient impairment of renal function were observed. Similar changes in cellular immune parameters and clinical response were not observed in the controls. Our study suggests ciclosporin could modulate the cellular immunity in IgA nephropathy.
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