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Insofar as it exerted its immunosuppressive effect by inhibiting cytokine expression, we assessed the effect of FK506 (Tacrolimus) on cytokine-stimulated T-cell activation. Human T cells, treated with FK506, or controls were stimulated with the mitogens PHA + PMA, Con A, and the "CD3-bypass" stimulation regimen, PMA + ionomycin. T-cell proliferation was quantitated by measuring the uptake of tritiated thymidine, and mRNA expression was assessed by RT-PCR. FK506, in a concentration-dependent fashion, inhibited T-cell proliferation and steady-state mRNA expression of IL-2 and IL-7; half-maximal suppression was obtained at 10(-7) to 5 x 10(-8) M. We tested whether FK506 antiproliferative effect could be overcome with exogenously reconstituted rIL-2 and/or rIL-7. Neither rIL-2 nor rlL-7, individually in conjunction with suboptimal concentrations of PHA or Con A, or in combination without any costimulus, was capable of abrogating FK506 antiproliferative effect, indicating that FK506 also acted by inhibiting cytokine-stimulated T-cell activation. To confirm this, T cells were treated with FK506 and stimulated by rIL-2 and rIL-7, individually in conjunction with suboptimal concentration of PHA and Con A. In addition, T cells were stimulated with rIL-2 and rIL-7 without any costimuli. FK506 inhibited T-cell activation stimulated by rIL-2 and by rIL-7, individually and in combination. This confirms that, in exerting its antiproliferative effect, FK506 acts at two levels, by inhibiting cytokine availability and by suppressing cytokine effect on target cells, and explains the beneficial effect of FK506 in attenuating ongoing immune responses.

The acute phototoxic potential of tacrolimus (FK506) ointment was investigated in Crl:SKH1-hr hairless mice. Response toa series of ultravioletradiation (UVR) site exposures in males (five group) following a single topical administration of tacrolimus ointment (0%[vehicle], 0.03%, 0.1%, 0.3%, 1%, or 3%) indicated that tacrolimus ointment was neither photoprotective or phototoxic. However, a slight but dose-related decrease in body weight relative to the vehicle control was found at the end of the 4-day observation period in the tacrolimus ointment-treated groups. The same concentrations of tacrolimus ointment were applied to the back and sides of mice (five sex group; ∼40% of total body surface area) 5 days week in a 13-week range-finding study to assess the tolerance to the ointment and UVR exposure. Untreated animals served as a control group. Mice were exposed to 72 minutes of UVR from a 6.5-kW xenon lamp. Mortality occurred in the 0.3%, 1%, and 3% ointment groups. Application of 3% tacrolimus ointment was associated with reduced body weight. Mild to moderate erythema and/or edema were noted in all tacrolimus ointment-treated groups. Histopathologi-cal examination indicated a mild increase in the prominence of the stratum granulosum and mild acanthosis of the epidermis in both vehicle-treated and tacrolimus ointment-treated mice. Stomach, esophageal, and/ or abdominal cavity lesions, indicative of systemic toxicity and possibly associated with the in gestion of ointment vehicle during preening, were observed during necropsy. There was minimal photo-mediated dermal toxicity of tacrolimus ointment in the 13 weeks of exposure in the present study.