Cyclosporine A for neuroprotection: Establishing dosing guidelines for safe and effective use

Aaron M. Cook, Justin Whitlow, Jimmi Hatton, Byron Young

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Numerous neuroprotective compounds have been investigated to ameliorate secondary changes and the progression of injury after the primary insult in traumatic brain injury (TBI). This cascade of events is complex and difficult to abate once initiated following the primary injury. The clinical consequences of this secondary injury are unpredictable and often permanently incapacitating. Cyclosporine A (CsA) interrupts the endogenous mediators of secondary insult through inhibition of the mitochondrial permeability transition pore and prevention of subsequent mitochondrial dysfunction. This drug may have a role in neuroprotection but has several pharmacologic effects that must be considered when using it in the TBI population. This review discusses the physiologic responses following TBI that may affect CsA efficacy and safety when used for neuroprotective indications. So far, CsA seems to be safe in the TBI population. The role of CsA after acute TBI will be better defined after the completion of upcoming planned clinical trials.

Original languageEnglish
Pages (from-to)411-419
Number of pages9
JournalExpert Opinion on Drug Safety
Issue number4
StatePublished - Jul 2009


  • Cyclophilin D
  • Mitochondrial permeability transition pore
  • Secondary injury
  • Traumatic brain injury

ASJC Scopus subject areas

  • Pharmacology (medical)


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