Immunosuppressives in transplant rejection

摘要: A series of immunosuppressives is nowadays on the market or in advanced clinical development that are efficacious prevention treatment rejection a transplant patients with end-stage organ failure. These can roughly be divided into lowmolecular-weight XENOBIOTICS, orally active drugs produced by microorganisms chemical synthesis, and biologicals, (monoclonal) antibodies rDNA fusion proteins. Most XENOBIOTICS work intracellularly affect different pathways lymphocyte activation and/or proliferation; since such not truly selective for LYMPHOCYTES, most these show inherent side-effects generally have low therapeutic window. However, availability novel agents broader window, refinements combination greatly added to improved tolerability immunosuppressive regimens. Broadly acting cytotoxic severe gradually being replaced compounds more action towards lymphoid cells, corticosteroid-sparing regimens applied reduce adverse corticosteroids. biologicals binding cell surface molecules, resulting inactivation depletion target cells. Progress this area has only resulted IMMUNOSUPPRESSION, but also potential approaches induce status unresponsiveness, i.e., TOLERANCE transplant. This achieved either efficient reactive cells inhibition second signals coreceptor blockade T CELL activation. New paradigms IMMUNOSUPPRESSION involve interference trafficking (lymphocyte recirculation) appears possible using innovative ADHESION MOLECULES.