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Tacrolimus and Rapamycin do not elevate cholesterol synthesis in post‐transplant patients, but may impair response to multi‐nutrient dietary intervention
Author(s) -
Lambert Jennifer E,
Ryan Edmond A,
Thomson Alan BR,
Clandinin Michael T
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.971.45
Subject(s) - tacrolimus , medicine , cholesterol , triglyceride , hyperlipidemia , ctl* , gastroenterology , transplantation , endocrinology , immunology , immune system , diabetes mellitus , cd8
Patients frequently experience hypercholesterolemia after transplant due to immunosuppressive drugs. Mechanisms responsible for this rise in plasma cholesterol are not clear. Dietary therapy is usually not sufficient to reduce plasma cholesterol post‐transplant, however these interventions may be limited in scope. The purpose of this study was to investigate cholesterol synthesis as a possible mechanism for hypercholesterolemia in post‐transplant patients, and test the efficacy of a multi‐faceted dietary intervention. Islet (ITx; n=8) and liver (LTx; n=7) post‐transplant patients on Tacrolimus (Tac) or Rapamycin (Rapa) were recruited with normal control subjects (Ctl; n=9) to measure 24h cholesterol fractional synthesis (FSR‐C) using deuterium. A subset of patients underwent a 4‐week dietary intervention using fish oil, phytosterols, soy, and fibers. FSR‐C was not different between Ctl, ITx and LTx groups. Diet intervention significantly lowered plasma cholesterol and triglyceride in Ctl, however was not effective in ITx or LTx. Diet produced mixed results in changes in FSR‐C across groups. In conclusion, hyperlipidemia caused by Tac or Rapa may not be due to elevated cholesterol synthesis. However, these drugs may interfere with normal responses to hypolipidemic dietary therapy effective in non‐transplant populations. Grant Funding Source : Canadian Institutes of Health Research