title: Adverse effects of immunosuppressant drugs upon airway epithelial cell and mucociliary clearance: implications for lung transplant recipients.
abstract: Optimal post-transplantation immunosuppression is critical to the survival of the graft and the patient after lung transplantation. Immunosuppressant agents target various aspects of the immune system to maximize graft tolerance while minimizing medication toxicities and side effects. The vast majority of patients receive maintenance immunosuppressive therapy consisting of a triple-drug regimen including a calcineurin inhibitor, a cell cycle inhibitor and a corticosteroid. Although these immunosuppressant drugs are frequently used after transplantation and to control inflammatory processes, limited data are available with regard to their effects on cells other than those from the immunological system. Notably, the airway epithelial cell is of interest because it may contribute to development of bronchiolitis obliterans through production of pro-inflammatory cytokines. This review focuses the current armamentarium of immunosuppressant drugs used after lung transplantation and their main side effects upon airway epithelial cells and mucociliary clearance.
authors.affiliation: Laboratory of Thoracic Surgery Research-LIM61, Department of Cardiopneumology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, 1o. Andar, Sala 1220, Pacaembu, São Paulo, SP, 01246-000, Brazil. rogeriopazetti@yahoo.com.br
authors.forename: Rogerio
authors.initials: R
authors.lastname: Pazetti
authors.forename: Paulo Manuel
authors.initials: PM
authors.lastname: Pêgo-Fernandes
authors.forename: Fabio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D004359:Drug Therapy, Combination; D004847:Epithelial Cells / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016040:Lung Transplantation; D009079:Mucociliary Clearance / Q000187:drug effects*; D020545:Respiratory Mucosa / Q000187:drug effects*
chemical_list: D007166:Immunosuppressive Agents