Is sirolimus a nephrotoxic drug? A report of five cases
| Autor: | A.E. Elagroudy, M.A.A. El-Rahim, K.F. El-dahshan, Alaa Sabry, M.A. Sobh |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Kidney Glomerulus Pharmacology Organ transplantation Focal segmental glomerulosclerosis medicine Humans Antibacterial agent Sirolimus Transplantation business.industry Immunosuppression medicine.disease Kidney Transplantation Tacrolimus Calcineurin surgical procedures operative Immunology Kidney Failure Chronic Surgery business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation proceedings. 39(5) |
| ISSN: | 0041-1345 |
| Popis: | HE CHOICE OF immunosuppression after organ transplantation is expanding. The past decade has seen the introduction of tacrolimus, mycophenolate mofetil (MMF), and an array of monoclonal antibodies. 1 Calcineurin inhibitors have been a cornerstone of transplant immunosuppression, beginning with the introduction of cyclosporine in 1978 and then tacrolimus in 1989, but nephrotoxicity limits their therapeutic benefit. 2 With the addition of mycophenolate mofetil in 1991, 1-year kidney graft survival rates have improved to greater than 90%. 3 Rapamycin (Rapa) is a new immunosuppressive medication that prolongs allograft survival. It was initially investigated as an antifungal and antitumor agent; however, its lymphopenic properties heralded its role as an immunosuppressant agent. The therapeutic effects of Rapa are derived from the inhibition of proliferation of fibroblasts, endothelial, mesangial and smooth muscle cells. 4 Sirolimus binds to the immunophilin FK506-binding protein-12 with greater avidity than tacrolimus. Animal studies have shown that sirolimus and tacrolimus act synergistically to prevent rejection. 5 Herein we have presented five cases of focal segmental glomerulosclerosis (FSGS) in Egyptian renal transplant patients; both de novo and recurrent FSGS were associated with sirolimus-based immunosuppression. |
| Databáze: | OpenAIRE |
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