Torre MF

Language: Spanish
References: 5
Page: 70-73
PDF size: 176.60 Kb.

ABSTRACT

The use of tacrolimus as a mycotic suppressor agent has shown its benefits in patients with heart, slung, liver kidney, small intestine and spinal cord transplantation. However, it usually presents contraindications in some patients; therefore, one must be careful in its use.
Obtained through the fermentation of Streptomyces tsukubaensis, in Japan, tacrolimus is from 10 to 100 times-fold more powerful than cyclosporine. It is used for the treatment of atypical dermatitis in adults and children.
Tacrolimus induces immunosuppression by the inhibition of the first phase in the activation of T cells. In this phase, it is activated the transcription of certain factors that allow the T cells to progress from the G0 Phase into the G1 phase. Tacrolimus fixes itself to an immunophilin, the FKBPB12 immunophilin, in order to generate a complex that inhibits calcineurin phosphatase activity and catalyzes a dephosphorylation reaction, which is critical for the transcription of the linfocine gene. The reduction of the levels of the activators in T cells reduces the proliferative response of these cells in front of antigens and mitogens. All of these actions provoke a decrease in the recognition of antigens and the regulation of the inflammatory effects in serious blepharoconjunctivitis. The administration is given oral, parenteral or atopic via with the recommendation of the parenteral choice because of its more direct action.
Among the precautions to be taken into account when administrating this medicine, it should be mention the avoidance of sun exposure and phototherapy. It must not be administrated either in pregnant women or children younger than two years old. When using tacrolimus ointment, eye contact must be avoided too.
Among the sufferings in which tacrolimus may be used, it can be mentioned: blepharoconjunctivitis, staphylococcia, seborrhea, Meibomian dysfunction, atopic keratoconjunctivitis associated with rosacea and dry-eye keratoconjunctivitis.

REFERENCES

1. Staatz CE, Tett SE. Clinical pharmacokinetic and pharmacodynamics of tacrolimus in solid organ transplantation. Clinical Pharmacokinetics 2004; 43(10): 623-54 (ref. 1).

2. Thelmo MC, Lang W, Brooke E, Osborne BE, McCarty MA, Jorizzo JL, Fleicher AB. An Openlabel pilot study to evaluate the safety and efficacy of topically applied tacrolimus ointment for the treatment of hand and/or foot eczema. Journal of Dermatological Treatment 2003; 14(3): 136-541 (ref 2).

3. Fleischer AB. Treatment of atopic dermatitis: role of tacrolimus ointment as a topical noncorticosteroid therapy. J Allergy Clin Inmunol 1999; 104-S126-30.

4. Ruzicka T, Schopt E et al. A short term trial of tacrolimus ointment for atopic dermatitis. N Engl J Med 1997; 337: 816-21.

5. Hannele MV, Sakari R, Marjatta K, Osmo K. Effect of 0.003% tacrolimus ointment on conjuntival cytology in patients with severe atopic blepharoconjuntivitis: a retrospective study. Acta Oftalmológica Scandinavica 84(5): 693-695 doi: 10.1111/j.1.600-o420.2006.00699.x.