New immunosuppressive drugs: an update.
An increasing number of immunosuppressive drugs became available for clinical use over the past few decades. These include substances with recently recognized immunosuppressive properties, which needed careful evaluation in various trials before they could be approved for use in different diseases. The effectiveness of other agents was already established, but knowledge about their modes of action or the mechanisms that lead to side effects was acquired much later. This understanding also contributed to the development of new drugs that display synergistic effects or lack certain adverse effects. The greater choice afforded by such research endeavours allows us to select the best therapeutic strategy for an individual patient; however, this requires a comprehensive knowledge of the available options. The present review provides an update of current knowledge of the most important substances (including calcineurin and target of rapamycin inhibitors, regulators of gene expression, and inhibitors of purine and pyrimidine synthesis) and surveys some of the novel agents that are expected to play an important role in the future.
Department of Nephrology and Dialysis, Clinic of Internal Medicine III, University of Vienna, Medical School, Vienna, Austria. pohanka@nephro.imed3.akh-wien.ac.at
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Pohanka
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000477:Alkylating Agents / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D000068876:Fingolimod Hydrochloride; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D011409:Propylene Glycols / Q000627:therapeutic use; D011687:Purines / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D011743:Pyrimidines / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D020123:Sirolimus / Q000037:antagonists & inhibitors; D013110:Sphingosine / Q000031:analogs & derivatives; D014807:Vitamin D / Q000031:analogs & derivatives / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000477:Alkylating Agents; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D011687:Purines; D011743:Pyrimidines; D014807:Vitamin D; D000068876:Fingolimod Hydrochloride; C030986:pyrimidine; D013110:Sphingosine; D020123:Sirolimus; C030985:purine