cyclosporin A   Click here for help

GtoPdb Ligand ID: 1024

Synonyms: ciclosporin | cyclosporine | cyclosporine A | Ikervis® (opthalmic solution) | Neoral® | Sandimmun® | Verkazia® (opthalmic solution)
Approved drug Immunopharmacology Ligand
cyclosporin A is an approved drug (FDA and UK (1983), EMA (2015))
Comment: Originally isolated from Tolypocladium inflatum, cyclosporin A acts as a calcineurin inhibitor.
There is some ambiguity in the literature as to the exact stereochemistry of cyclosporin A. Other common representations on PubChem are CID 5280754, and CID 24883466.
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View more information in the IUPHAR Pharmacology Education Project: cyclosporin a

2D Structure
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SMILES / InChI / InChIKey
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Canonical SMILES CC=CCC(C(C1C(=O)NC(CC)C(=O)N(C)CC(=O)N(C)C(CC(C)C)C(=O)NC(C(C)C)C(=O)N(C)C(CC(C)C)C(=O)NC(C(=O)NC(C(=O)N(C(C(=O)N(C(C(=O)N(C(C(=O)N1C)C(C)C)C)CC(C)C)C)CC(C)C)C)C)C)O)C
Isomeric SMILES C/C=C/C[C@H]([C@H]([C@H]1C(=O)N[C@@H](CC)C(=O)N(C)CC(=O)N(C)[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N(C)[C@@H](CC(C)C)C(=O)N[C@H](C(=O)N[C@@H](C(=O)N([C@H](C(=O)N([C@H](C(=O)N([C@H](C(=O)N1C)C(C)C)C)CC(C)C)C)CC(C)C)C)C)C)O)C
InChI InChI=1S/C62H111N11O12/c1-25-27-28-40(15)52(75)51-56(79)65-43(26-2)58(81)67(18)33-48(74)68(19)44(29-34(3)4)55(78)66-49(38(11)12)61(84)69(20)45(30-35(5)6)54(77)63-41(16)53(76)64-42(17)57(80)70(21)46(31-36(7)8)59(82)71(22)47(32-37(9)10)60(83)72(23)50(39(13)14)62(85)73(51)24/h25,27,34-47,49-52,75H,26,28-33H2,1-24H3,(H,63,77)(H,64,76)(H,65,79)(H,66,78)/b27-25+/t40-,41+,42-,43+,44+,45+,46+,47+,49+,50+,51+,52-/m1/s1
InChI Key PMATZTZNYRCHOR-CGLBZJNRSA-N
No information available.
Summary of Clinical Use Click here for help
Cyclosporine is a powerful immunosupressant. Its inhibitory action on T-lymphocyte activation is used to circumvent graft rejection following autologous organ and tissue transplant. It can also be used to treat severe active, refractory rheumatoid arthritis and severe recalcitrant plaque psoriasis. Across the European Union ophthalmic solutions of cyclosporin are fully approved for the treatment of severe keratitis (corneal inflammation) and severe vernal keratoconjunctivitis (a form of chronic eye allergy that can lead to corneal ulcers and loss of sight; in patients aged 4yrs- adolescent), and it has current orphan designation for 8 indications (click here to link to the EMA's list of orphan designations for cyclosporin).
In August 2018 the FDA approved a 0.09% cyclosporine ophthalmic solution called Cequa® as a topical treatment for keratoconjunctivitis sicca (dry eye).
Mechanism Of Action and Pharmacodynamic Effects Click here for help
Cyclosporin A must form a complex with its immunophilin 'receptor', cyclophilin A (PPIA), before it is able to bind and inhibit calcineurin [7]. It is the inhibition of the phosphatase activity of calcineurin by this drug-protein complex that results in immunomodulatory actions. The overall effect is inhibition of T-lymphocyte activity, including inhibition of production and release of lymphokines such as interleukin-2.
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