The Treatment of Idiopathic Membranous Nephropathy by Immunosuppressants in Chinese Mainland

【Abstract】
In Chinese mainland, the incidence of Idiopathic Membranous Nephropathy （IMN） is increasing. If the treatment is not efficient, IMN will gradually progress to end stage renal disease （ESRD）. The specific treatment of IMN is mainly immunosuppressive therapies. The review was performed to summarize the application and progress of immunosuppressants for IMN in Chinese Mainland, so as to provide relevant evidences for clinical research and treatment.

【Key words】
Idiopathic Membranous Nephropathy, Immunosuppressants, review, Chinese Mainland

Current Status and Future Insights of the Application of Immunosuppressive Drugs in Hematology in China

【Abstract】
The pathogenesis of hematological diseases is complex. Most of them are usually in critical condition with poor prognosis and difficult clinical treatment. It is a type of diseases that seriously threaten the life and health of Chinese people. In recent years, with the rapid development of basic and clinical research in immunology in the field of hematology, immunotherapy has emerged, and it is expected to improve the efficacy of the hematological diseases treated by traditional therapy. This paper will discuss the current status of the application of immunosuppressive drugs in China, with a view to the prospect of
immunosuppressive drugs in the field of hematology.

【Key words】
Hematological diseases, Blood diseases, Immunotherapy, Immunosuppressive agents

Current topics of immunosuppression and preservation for organ transplantation

【Abstract】
Genetic substitution, even in the immunosuppression for organ transplantation has been promoting in national health insurance system for Japan. Intensive drug monitoring may be required in genetic substitution, especially in the case of mycofenorate mofetil. Immunosuppressive agents of which TDM monitoring is recommended to optimize the individual dose in the transplant recipients are also required to substitute from original bland to genetic, even though their pharmacokinetics are not equal. The drig monitoring may be required in even genetic MMF. There are two methods for transplant organ preservation in the world; Simple static cold preservation（CS）and machine perfusion preservation（MP）. Recently, our research group reported the beneficial effects of human artificial hemoglobin vesicle, （artificial blood）as a preservation solution for MP. This study will promise ex vivo organ treatment including immunosuppression before transplantation.

【Key words】
genetic MMF, organ preservation, ex vivo immunotherapy

Current issues of immunosuppressive agents for organ transplantation in Japan.
―― TDM for tacrolimus as the typical agent

【Abstract】
Tacrolimus, a calcineurin inhibitor, is an important immunosuppressive agent in organ transplantation. Since many factors affecting tacrolimus pharmacokinetics alter the blood concentration, therapeutic drug monitoring （TDM） is required to adjust the tacrolimus dosage for individual patient. In this review, current use of tacrolimus for organ transplantation in terms of the pharmacokinetics aspects including CYP3A5 genotype, drug-food and drug-drug interaction. Switching the original formulation of tacrolimus to generic ones is also discussed in the clinical practice in Japan.

【Key words】
tacrolimus, pharmacokinetics, generic, genotype, drug-food interaction