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Ann Thorac Surg 1990;49:129-132
© 1990 The Society of Thoracic Surgeons

Articles

Bromocriptine as an adjuvant to cyclosporine immunosuppression after heart transplantation

Michel Carrier, MD*,a,b, Joan Wild, MTa,b, L.Conrad Pelletier, MDa,b, Jack G. Copeland, MDa,b

a Department of Surgery, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
b Department of Cardiothoracic Surgery, University of Arizona, Tucson, Arizona USA

Accepted for publication September 29, 1989.

* Address reprint requests to Dr Carrier, Montreal Heart institute, 5000 Belanger St, Montreal, Que, Canada HIT 1C8.


   Abstract
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 Abstract
References
 
Prolactin, a pituitary hormone, has been shown to have an active role in the regulation of the immune system. Prolactin receptors have been described on the membrane of lymphocyte cells, and competitive binding to these receptors by cyclosporine and circulating prolactin has been demonstrated. Experimental evidence suggests a synergistic effect of cyclosporine and bromocriptine, an inhibitor of pituitary release of prolactin, on immunosuppression. Between July 1986 and January 1988, 54 patients were randomly assigned to two groups of immunosuppression treatment. Thirty patients (group 1) were administered cyclosporine, azathioprine, and prednisone and 24 patients (group 2), a modified protocol aimed at decreasing the level of circulating prolactin by adding bromocriptine to the immunosuppression regimen. The two groups were similar in regard to age, preoperative diagnosis, and duration of follow-up. Minimal side effects related to bromocriptine were observed. The overall incidences of rejection and infection were similar, although actuarial analysis showed that freedom from these complications among patients treated with bromocriptine was significantly higher throughout the first 2 months after heart transplantation compared with that of patients in the control group. Other variables such as serum cyclosporine levels and lymphocyte counts were similar in both groups. In conclusion, suppression of circulating prolactin by bromocriptine appears to improve the immunosuppressive effect of cyclosporine, at least during the early postoperative period when the risk of rejection and infection is higher, and could be a promising avenue to successful hormonal manipulations of the immune process after organ transplantation.


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 Abstract
 References
 

  1. Heck CF, Shumway SL, Kaye MP. The registry of the International Society for Heart Transplantation: sixth official report 1989 J Heart Transplant 1989;8:271-276.[Medline]
  2. Emery RW, Cork R, Christensen R, et al. Cardiac transplant patient at one year: cyclosporine vs conventional immunosuppression Chest 1986;90:29-33.[Medline]
  3. Nagy E, Berezi I, Wren GE, et al. Immunomodulation by bromocriptine Immunopharmacology 1983;6:231-243.[Medline]
  4. Russell DH, Kibler R, Matrisian L, et al. Prolactin receptors on human T and B lymphocytes: antagonism of prolactin binding by cyclosporine J Immunol 1985;34:3027-3031.
  5. Russell DH, Larson DF, Cardon SB, Copeland JG. Cyclosporine inhibits prolactin induction of omithine decatboxylase in rats tissue Mol Cell Endocrinol 1984;35:159-166.[Medline]
  6. Russell DH, Matrisian L, Kibler R, et al. Prolactin receptors on human lymphocytes and their modulation by cyclosporine Biochem Biophys Res Commun 1984;121:899-906.[Medline]
  7. Hiestand PC, Gale JM, Mekler P. Soft immunosuppression by inhibition of prolactin release: synergysm with cyclosporine in kidney allograft survival and in the localized graft versus host reaction Transplant Proc 1986;18:870-872.
  8. Palestine AG, Muellenberg-Coulombe CG, Kim MY, et al. Bromocriptine and low-dose cyclosporine in the treatment of experimental autoimmune uveitis in the rat J Clin Invest 1987;79:1078-1081.[Medline]
  9. Palestine AG, Nussenblatt RB, Gelato M. Therapy for human autoimmune uveitis with low-dose cyclosporine plus bromocriptine Transplant Proc 1988;20:131-135.[Medline]
  10. Billingham ME. Diagnosis of cardiac rejection by endomyocardial biopsy J Heart Transplant 1981;1:25-30.
  11. Peto R, Pike MC, Armitage P, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient Br J Cancer 1977;35:1-39.[Medline]
  12. Carrier M, Emery RW, Wild-Mobley J, et al. Prolactin as a marker of rejection in human heart transplantation Transplant Proc 1987;19:3442-3443.[Medline]
  13. Carrier M, Russell DH, Wild JC, et al. Prolactin as a marker of rejection in human heart transplantation J Heart Transplant 1987;6:290-292.[Medline]
  14. Leblanc H, Lachalin GCL, Abu-Fadil S, Yen SSC. Effects of dopamine infusion on pituitary hormone secretions in human J Clin Endocrinol Metab 1976;43:668-674.[Abstract/Free Full Text]
  15. Parkes D. Bromocriptine N Engl J Med 1979;301:873-878.[Medline]
  16. Vance ML, Evans WS, Thorner MO. Bromocriptine Ann Intern Med 1984;100:78-91.[Medline]
  17. Greene PS, Cameron DE, Augustine S, Gardner TJ, Reitz BA, Baumgartner WA. Exploratory analysis of time-dependent risk for infection, rejection, and death after cardiac transplantation Ann Thorac Surg 1989;47:650-654.[Abstract/Free Full Text]
  18. Bolman RM, Olivari MT, Saffitz J, et al. Current results with triple therapy for heart transplantation Transplant Proc 1987;19:2490-2491.[Medline]



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