[Immunosuppressive drugs - how they work, their side effects and interactions]

Stucker, Fabien; Ackermann, Daniel (2011). [Immunosuppressive drugs - how they work, their side effects and interactions]. Therapeutische Umschau, 68(12), pp. 679-86. Bern: Huber 10.1024/0040-5930/a000230

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The central issue in organ transplantation remains suppression of allograft rejection. Immunosuppression can be achieved by depleting lymphocytes, diverting lymphocyte traffic, or blocking lymphocyte response pathways. Immunosuppressive drugs include small-molecule drugs, depleting and nondepleting protein drugs (polyclonal and monoclonal antibodies), fusion proteins, intravenous immune globulin, and glucocorticoids. Small-molecule immunosuppressive agents include calcineurin-inhibitors (cyclosporine, tacrolimus), Target-of-Rapamycin Inhibitors (Sirolimus, Everolimus), inhibitors of nucleotide synthesis and azathioprine. The review covers the mode of action of these drugs with a special focus on belatacept, a new promising fusion protein. Different immuo-suppressive strategies mean also different safety profiles. Common side effects include the consequences of diminished immuno- response, i.e. infections and cancer (mainly involving the skin). Toxic side effects of immunosuppressive drugs range in a wide spectrum that involves almost every organ. The major interest of this toxic effects is the cardiovascular tolerance (with large differences from drug to drug), that are discussed seperately. The calcineurin- and mTOR-inhibitors are both metabolized by the CYP450 3A4 enzyme, which is also involved in the metabolism of many other drugs. The review discusses the most important interactions that in- or decreases the through level of these drugs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

UniBE Contributor:

Ackermann, Daniel

ISSN:

0040-5930

Publisher:

Huber

Language:

German

Submitter:

Daniel Ackermann

Date Deposited:

04 Oct 2013 14:17

Last Modified:

05 Dec 2022 14:04

Publisher DOI:

10.1024/0040-5930/a000230

PubMed ID:

22139982

Web of Science ID:

A1982ND77100005

URI:

https://boris.unibe.ch/id/eprint/5345 (FactScience: 210085)

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