Treatment of transplant rejection: are the traditional immunosuppressants good enough?
Due to the improvement in the understanding of the anti-allogenic immune response, the success of transplantation medicine has increased rapidly over the last two decades. The knowledge that the T-lymphocyte played an integral role in transplant rejection, brought cyclosporine A and FK-506 to the fore as therapeutic immunosuppressants. However, the current mainstays in transplant rejection are not without their problems and many drug companies are exploring the possibilities of improving the available therapies by developing drugs with reduced toxicity, improved long-term survival and efficacy against chronic rejection and improved immunosuppressive selectivity. The advances in the understanding of T-cell activation and lymphocyte trafficking has highlighted ways to improve the existing therapies and more selective immunosuppressant targets.
Dumont
F J
FJ
Department  Immunology & Rheumatology, Merck Research Laboratories, Rahway, NJ 07065, USA. francis_dumont@merck.com
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000963:Antimetabolites / Q000737:chemistry / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000737:chemistry / Q000627:therapeutic use; D016207:Cytokines / Q000276:immunology; D015195:Drug Design; D000068876:Fingolimod Hydrochloride; D006084:Graft Rejection / Q000517:prevention & control*; D006146:Guanidines / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008213:Lymphocyte Activation / Q000187:drug effects; D015394:Molecular Structure; D016377:Organ Transplantation; D011409:Propylene Glycols / Q000737:chemistry / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D020123:Sirolimus / Q000737:chemistry / Q000627:therapeutic use; D013110:Sphingosine / Q000031:analogs & derivatives; D013601:T-Lymphocytes / Q000187:drug effects; D016559:Tacrolimus / Q000737:chemistry / Q000627:therapeutic use; D014315:Triterpenes / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D000963:Antimetabolites; D065095:Calcineurin Inhibitors; D016207:Cytokines; D006146:Guanidines; D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D014315:Triterpenes; C118657:correolide; D016572:Cyclosporine; D000068876:Fingolimod Hydrochloride; D013110:Sphingosine; C037258:gusperimus; D020123:Sirolimus; D016559:Tacrolimus