Interleukin-2 receptor antagonist induction in modern immunosuppression regimens for renal transplant recipients.
Addition of interleukin-2 receptor antagonist (IL-2RA) induction to calcineurin inhibitor (CNI)-based regimens reduces biopsy-proven acute rejection by 30-40%. IL-2RA induction facilitates early withdrawal of steroids, and supports the safe use of reduced-exposure CNI or delayed CNI introduction. IL-2RAs and rabbit antithymocyte globulin (Thymoglobulin) show comparable efficacy in patients at standard or low immunologic risk, but the adverse event profiles of lymphocyte-depleting agents are less favorable. IL-2RAs, uniquely, provide effective immunosuppression with similar tolerability to placebo.
Vincenti
Flavio
F
Transplant Service, University of California, San Francisco, San Francisco, USA. vincentif@surgery.ucsf.edu
de Andrés
Amado
A
Becker
Thomas
T
Choukroun
Gabriel
G
Cole
Edward
E
González-Posada
José M
JM
Kumar
Mysore A
MA
Moore
Richard
R
Nadalin
Silvio
S
Nashan
Björn
B
Rostaing
Lionel
L
Saito
Kazuhide
K
Yoshimura
Norio
N
D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001706:Biopsy; D065095:Calcineurin Inhibitors; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007376:Interleukin-2 / Q000378:metabolism; D053645:Interleukin-2 Receptor alpha Subunit; D016030:Kidney Transplantation / Q000379:methods*; D008954:Models, Biological; D010919:Placebos; D011817:Rabbits; D015375:Receptors, Interleukin-2 / Q000037:antagonists & inhibitors / Q000378:metabolism*
D000961:Antilymphocyte Serum; D065095:Calcineurin Inhibitors; C508017:IL2RA protein, human; D007166:Immunosuppressive Agents; D007376:Interleukin-2; D053645:Interleukin-2 Receptor alpha Subunit; D010919:Placebos; D015375:Receptors, Interleukin-2