Novel immunosuppressants

Abstract

Advances in maintenance immunosuppression over the past decade has resulted in dramatic improvements in short- and long-term outcomes in organ transplantation as well as a decreased incidence of acute rejection. However, immunosuppressive drugs need to be given long term, lack specificity, and are accompanied by adverse metabolic derangements, toxicities, the risk of infection and cancer, and a myriad of other side effects. Further, they fail to prevent and control chronic rejection. This review will outline a number of immunosuppressive agents that are currently being explored in experimental and clinical transplantation. These include biologic agents that have more specificity and selectivity, and are aimed at T-cell depletion, blockade of costimulation, adhesion markers, or at novel targets. Most of the studies have been limited to adults but should be applied to the pediatric population as well.

Chronic allograft nephropathy in paediatric renal transplantation

“…Of the other agents currently under investigation, there are only preliminary data on everolimus and the paediatric age group [63,64]. Tolerance strategies or strategies to minimise immunosuppression may provide some protection against both immune injury and CNI toxicity.…”

Icaritin inhibits T cell activation and prolongs skin allograft survival in mice

“…Therapeutic interventions to such diseases are often designed to reduce the threshold of T cell activation [16]. Therefore, immnosuppressive drugs, like cyclosporine A (CsA) and dexamethasone (Dex), are often used in these immune overwhelming diseases [20,21] In the present study, we found that icaritin at a quite low concentration could act as an immunosuppressant to reduce T cell proliferation, IL-2/CD25 expression, and Th1 cytokines production in vitro. To confirm the immune suppressive effect of icaritin in vivo, mouse skin transplantation, the standard model to assay host T cell responses to MHCdisparate donor antigens [22], was selected.…”

The Peptidyl-Prolyl Isomerase Pin1 Regulates Granulocyte-Macrophage Colony-Stimulating Factor mRNA Stability in T Lymphocytes

“…Immunosuppression can be accomplished by depleting cells, inducing tolerance, preventing the production of proinflammatory mediators, or blocking cell surface receptors (1,2). The predominant immunosuppressive drugs presently in clinical use consist of glucocorticoids and calcineurin inhibitors.…”