Sirolimus exposure during the early post‐transplant period reduces the risk of CMV infection relative to tacrolimus in renal allograft recipients

Abstract

These findings suggest that SRL as a component of a multidrug immunosuppressive regimen decreases the risk of CMV infection after kidney transplantation when compared with TCL.

Calcineurin inhibitor-free GVHD prophylaxis with sirolimus, mycophenolate mofetil and ATG in Allo-SCT for leukemia patients with high relapse risk: an observational cohort study

“…8,36 Of interest, we did not observe any systemic CMV reactivation, despite the seropositivity of two of three of the patients. This is in accordance with observations suggesting a CMV protective effect of sirolimus-based immunosuppression after solid organ transplantation 42,43 and, as recently published, also after hematopoietic SCT. 30 The mechanism(s) by which sirolimus may exert this protective effect remain to be determined.…”

Evaluation of Cytomegalovirus (CMV)–Specific T Cell Immune Reconstitution Revealed That Baseline Antiviral Immunity, Prophylaxis, or Preemptive Therapy but not Antithymocyte Globulin Treatment Contribute to CMV‐Specific T Cell Reconstitution in Kidney Transplant Recipients

“…Another hypothesis is that innate immunity mechanisms may be sufficient to keep latent CMV under control. Another mechanism that may control virus replication may be the mTOR inhibitor treatments that have been previously shown to reduce the incidence of viremia [25,26]. In this study, we have not found statistically relevant differences in CMV viremia and CMV-specific T cell reconstitution between patients treated with mTOR inhibitors and patients who received other treatments, such as mycophenolate mofetil or ATG (data not shown).…”

Sirolimus Enhances the Magnitude and Quality of Viral-Specific CD8+ T-Cell Responses to Vaccinia Virus Vaccination in Rhesus Macaques

“…This effect has been observed in studies of both bone marrow and solid organ transplantation (12, 13). While the mechanisms of this protection are currently unknown, there has been speculation in the literature that sirolimus may exert this effect directly by inhibiting viral replication (11).…”