Cyclosporin A is a hormonal immunomodulator. I. Human study.

The immunosuppressant Cyclosporin A (CS) is known to induce 2 hormonal disorders as side effects of its long-term use: gynecomastia in male subjects and hirsutism in female subjects. The present study was started to investigate the problem of whether or not the above steroid-mimetic actions of CS are to be related to the immunosuppressive effect of that substance. Practically, a case-control comparison of 14 urinary steroid excretions was made for each sex with healthy controls and kidney transplant recipients undergoing CS-free and CS-dependent immunosuppressive treatments on the one hand, and the success rate of kidney transplantation was compared between the CS-free treatment group and the CS-dependent treatment group on the other hand. The results obtained are follows: 1) Both the CS-free- and CS-dependent-treatments produced a general depression of all androgens, progestins and corticosteroids in the urine. The suppressive effect on urinary steroid excretions was more marked in the latter than in the former. Under the same CS-free treatment, the excretion of tetrahydrocortisol (THF) was intact in male patients and was significantly depressed in female patients. 2) A remarkable difference between the 2 immunosuppressive treatment groups was found in the ratio of urinary androsterone (AD) to urinary THF, an index of androgen to glucocorticoid balance: the praxis of CS-free treatment significantly depressed log AD/THF in patients of both sexes, the ratio being much higher in normal males than in normal females.(ABSTRACT TRUNCATED AT 250 WORDS)