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Nephrol Dial Transplant (2001) 16: 18-20
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Sirolimus: a new promising immunosuppressive drug. Towards a rationale for its use in renal transplantation

Emmanuel Morelon, Marie-France Mamzer-Bruneel, Marie-Noëlle Peraldi and Henri Kreis

Service de Transplantation, Hôpital Necker, Paris, France

Keywords: immunosuppressive drugs; rapamycin; renal transplantation; sirolimus

Introduction

For about 30 years, maintenance immunosuppression in the field of organ transplantation has been limited by the availability of only three drugs: corticosteroids, azathioprine, and cyclosporin. For the last 10 years, however, new immunosuppressive agents such as tacrolimus and mycophenolate mofetil (MMF) have been developed and are now available for transplant patients. Sirolimus (rapamycin), the latest one, is still being developed. It seems a very promising immunosuppressive drug which could in future replace calcineurin inhibitors such as cyclosporin.

Originally described in 1975 as an antibiotic of the macrolide family [1] the immunological activity of sirolimus was reported in 1977 in a rodent model of autoimmune encephalomyelitis [2]. However, it is only recently that its effect on the immune system has generated great interest, because its structure resembles that of tacrolimus, another potent immunosuppressive macrolide [3]. Both in vitro and preclinical studies have confirmed the . . . [Full Text of this Article]

Mechanisms of action

Absence of nephrotoxic effects

Use of sirolimus in human renal transplantation

Combination of sirolimus and cyclosporin
Sirolimus as base immunosuppressive therapy
Adverse events

Conclusions and prospects

Note added in proof

Notes

References


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