title: Belatacept: a new era of immunosuppression?
abstract: Full T-cell activation in alloimmunity requires the engagement of several costimulatory molecules. CTLA-4-Ig and its commercially available fusion proteins, belatacept and abatacept, are used to block CD80/86 and promote T-cell tolerance. Belatacept, a higher binding affinity molecule, is currently approved for clinical use in renal transplantation. The results of two Phase III clinical trials showed a similar patient/graft survival, with better renal function at a 3-year follow-up compared with conventional immunosuppression. There was a higher risk of early rejection and post-transplant lymphoproliferative disorder, especially with EBV-negative patients receiving kidneys from EBV-positive donors. Belatacept-treated groups had a better cardiovascular and metabolic profile. The authors review both preclinical and human studies of CTLA-4-Igs.
authors.affiliation: Department of Medicine, Division of Nephrology, Staten Island University Hospital, NY, USA.
authors.forename: Elie
authors.initials: E
authors.lastname: El-Charabaty
authors.forename: Abdallah Sassine
authors.initials: AS
authors.lastname: Geara
authors.forename: Christopher
authors.initials: C
authors.lastname: Ting
authors.forename: Suzanne
authors.initials: S
authors.lastname: El-Sayegh
authors.forename: Jamil
authors.initials: J
authors.lastname: Azzi
mesh_terms: D000069594:Abatacept; D000818:Animals; D002986:Clinical Trials as Topic; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D018796:Immunoconjugates; D007166:Immunosuppressive Agents; D000069594:Abatacept