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Questions and Case Studies: Steroids, Cyclosprine and Crohn's Disease

by Pravin Shukle, MD
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    Let's move on to some questions. Let's start with this one. Cyclosporine acts through the following mechanisms. A, reduction of calmodulin. B, increasing the activity of calcineurin. C, inhibiting the dephosphorylation of NFAT, with a reduction in interleukin 2. D, increasing NFAT activity. Or E, increasing cytostatic activity? Which one is it? Good, C. Inhibiting the dephosphorylation of NFAT, with a reduction in interleukin 2. So cyclosporine binds to cyclophilin to inhibit calcineurin from activity, which is to dephosphorylate nuclear factor of activated T-cells or NF-AT. Normally, calcineurin would cause increased transcription of your interleukin 2 and the cytokines. Cyclosporine, therefore, reduces levels of interleukin 2 and some cytokines and T-cell activity. Calmodulin is not affected by cyclosporine A. It has nothing to do with cyclosporine A. So A is incorrect. Cyclosporine does not affect the activity of interleukin 2. It reduces transcription of interleukin 2. So B is incorrect and C is correct. D is incorrect because it's a direct contradiction of C. Cyclosporine decreases NFAT activity. And finally, cyclosporine does not affect cytotoxic or cytostatic activity. Cytostatic activity, there is no such thing, it's a misnomer. So, remember that we are talking about cytotoxic activity. This was actually a question in one of the exams and it ended up getting thrown out because of the word cytostatic. And they felt that they were trying to trick students. So the good news for you is, is that remember that no one is trying to trick you, but it's a very good question because you are going to be asked questions like this with cyclosporine, but without the tricks. Let's try another question. Your 55 year old male patient has refractory inflammatory bowel disease. The gastroenterologist has started the patient on oral steroids and cyclosporine. You saw him one month...

    About the Lecture

    The lecture Questions and Case Studies: Steroids, Cyclosprine and Crohn's Disease by Pravin Shukle, MD is from the course Gastrointestinal Pharmacology. It contains the following chapters:

    • Question: Cyclosporine Forum
    • Case Study 1: Steroids and Cyclosporine
    • Case Study 2: Crohn's Disease
    • Case Study 3: Crohn's Disease Medication

    Author of lecture Questions and Case Studies: Steroids, Cyclosprine and Crohn's Disease

     Pravin Shukle, MD

    Pravin Shukle, MD


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