title: Sirolimus in solid organ transplantation: current therapies and new frontiers.
abstract: Sirolimus (SRL) is a mammalian target of rapamycin inhibitor, which provides an immunosuppressive effect by inhibiting cell cycle progression. The encouraging results of combined SRL-cyclosporine therapy paved the way to further immunosuppressant combinations. Although SRL is relatively non-nephrotoxic when administered as monotherapy, it pharmacodynamically enhances the toxicity of calcineurin inhibitors. Other side effects may include hyperlipidemia and myelosuppression and less commonly wound healing impairment, proteinuria, edema and pneumonitis. Surprisingly, SRL also showed encouraging properties as an antiatherogenic and antineoplastic, opening a large spectrum of new potential applications. Whether SRL can be used safely over the long term with low doses of calcineurin inhibitors requires further study. The use of SRL as a corticosteroid-sparing agent also remains to be proven in controlled trials.
authors.affiliation: Vascular Surgery & Organ Transplant Unit, Department of Surgery, Transplantation & Advanced Technologies, University Hospital of Catania, Via Santa Sofia, 83 95128 Catania, Italy. veroux@unict.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Veroux
authors.forename: Tiziano
authors.initials: T
authors.lastname: Tallarita
authors.forename: Daniela
authors.initials: D
authors.lastname: Corona
authors.forename: Antonino
authors.initials: A
authors.lastname: D'Assoro
authors.forename: Carmelina
authors.initials: C
authors.lastname: Gurrieri
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Veroux
mesh_terms: D002453:Cell Cycle / Q000187:drug effects; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology; D007165:Immunosuppression Therapy; D016377:Organ Transplantation; D020123:Sirolimus / Q000009:adverse effects / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D020123:Sirolimus