This document summarizes information about cyclosporine, an immunosuppressant drug used to prevent organ transplant rejection. It was first isolated from the fungus Tolypocladium inflatum in 1970. Cyclosporine is a cyclic polypeptide composed of 11 amino acids that suppresses T cell activity. It is used to prevent rejection of kidney, heart, and liver transplants and is also approved to treat severe psoriasis and rheumatoid arthritis. While an effective immunosuppressant, cyclosporine can increase risks of high blood pressure, kidney problems, and cancer growth due to its suppression of the immune system.

2. We’ll discuss the following:
 Introduction.
 History of Cyclosporine.
 Scientific Classification.
 Structure of Cyclosporine.
 Uses of cyclosporine.
 Plaque Psoriasis Patients.
 How Does Cyclosporine Work?
 Negative Effects of Cyclosporine.
 Forms of Cyclosporine.

3. Introduction
 is an immunosuppressant drug widely used in organ
transplantation to prevent rejection.
 It reduces the activity of the immune system by interfering
with the activity and growth of T cells.
 It was initially isolated from the fungus Tolypocladium
inflatum (Beauveria nivea), found in a soil sample.
 Most peptides are synthesized by ribosomes, but
 ciclosporin is a cyclic nonribosomal peptide of
 11 amino acids and contains a single D-amino acid,
 which are rarely encountered in nature.

4. History of Cyclosporine
 Comes from the fungus Tolypocladium inflatum which was
discovered in 1970.
 Tolypocladium inflatum was isolated from Norwegian soil samples.
 Found to be immunosuppressant-- cyclosporine in 1976 by J. F. Borel
 Cyclosporine was approved for use in 1983 to prevent graft
rejection in transplants.
 Approved for the treatment of severe psoriasis in 1997.

5. Scientific Classification
 Kingdom: Fungi
 Phylum: Asomycota
 Class: Sordariomycetes
 Subclass: Sordariomycetidae
 Order: Hypocreales
 Family: Ophiocordycipitaceae
 Genus: Tolypocladium
 Species: T. inflatum

6. Structure of Cyclosporine
 It was shown to have 11 amino acids
and was determined to play a
significant role in organ transplants.
 Cyclic polypeptide .
 Ciclosporin is synthesized by a non-
ribosomal peptide synthetase,
ciclosporin synthetase.

7. Uses of cyclosporine
 Is an immunosuppressant which suppress or reduce the strength of the
immune system
 Cyclosporine is used to prevent transplant rejection in people who have
undergone kidney, heart and liver transplants.
 It is approved in the US for the treatment of rheumatoid arthritis,
severe psoriasis and as an ophthalmic emulsion for the treatment of dry eyes
(Restasis).
 Also used in severe atopic dermatitis ,Kimura's disease, pyoderma
gangrenosum, chronic autoimmune urticaria

8. Plaque Psoriasis Patients
 Plaque psoriasis is a chronic inflammatory skin condition that is partially due to an
overactive immune system. It causes the body to grow skin cells at a rapid rate
causing these skin cells to pile on top of each other forming red patches--- plaque.
 In 1997, the Federal Drug administration approved Neoral (cyclosporine) for the
treatment of patients with severe psoriasis.
 Usage of cyclosporine suppresses the growth of skin cells
 Only used for SEVERE plaque psoriasis if prior methotrexate use is insufficient.
 Cyclosporine is highly effective in clearing psoriasis and can prevent relapse.
 Not recommended for people who have a weak immune system since cyclosporine
is an immunosuppresant.
 Side effects
 Kidney problems
 High BP
 Skin cancer

9. How Does Cyclosporine Work?
 As cyclosporine enters the body, it suppresses T- cell
function.
 Reducing T- cell function will enable successful
transplantation since T cells purpose of function is to kill
off objects viewed as foreign.
 Cyclosporine reduces the T cell function without
affecting B cell function and the production of
antibodies. Therefore, suppressing T-cell function allows
for the transplanted organ to be accepted without a
problem.
 Not all organ transplants will be rejected by the body.
However, cyclosporine is used as precautionary
measures.

10. Negative Effects of Cyclosporine
 Because cyclosporine is an immunosuppressant, it may cause patients to
be vulnerable to OTHER health problems. IT IS VERY TOXIC!!!
 Usage of cyclosporine may cause high BP, kidney problems. It also
encourages cancerous tumor growth.
 Side effects: headache, vomiting, nausea, diarrhea, upset stomach,
cramps, increased hair growth, tremor, swollen/red/painful gums,
dizziness.
 Serious side effects: dark urine, persistent nausea/vomiting, severe
stomach/abdominal pain, yellowing of the skin/eyes, vomit that looks like
coffee grounds, change in the appearance or size of skin moles/lesions,
changes in skin color, loss of consciousness, mental/mood changes,
vision changes, swollen glands, unusual lumps, night sweats

11. Forms of Cyclosporine
 This medicine is usually given 4 to 12 hours before organ
transplantation via needle placed in a vein
 Comes in the form of oral capsule and solution (liquid)
 Solution must be mixed with a liquid such as orange juice or milk.
NO GRAPE FRUIT OR GRAPEFRUIT JUICE!!!
 Comes in the brand name Gengraf, Neoral, Sandimmune Capsules,
Sandimmune Oral solution

12. Done by:
 Mohammed Abdo Amer
 Ahmed Adeeb Al-Shami
 Idrees Abdul-Rahman Al-Hassani
 Mohammed Al-Ahnomi
 Jalal Mo3eedh Khamousi
 Assad Al-Najjar
 Ahmed Saleh Al-Farrari
Supervised by:
 Dr. Hassan A. Al-Shamahy