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Nephrol Dial Transplant (1999) 14: 2087-2089
© 1999 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Rapamycin on trial

Steven H. Sacks

Guy's, King's College and St Thomas' Hospitals' Medical School, Renal Medicine and Transplantation, Guy's Hospital, London, UK

Correspondence and offprint requests to: Steven H. Sacks, Guy's, King's College and St Thomas' Hospitals' Medical School, Renal Medicine and Transplantation, 5th Floor, Thomas Guy House, Guy's Hospital, London SE1 9RT, UK. E-mail: steven.sacks@kcl.ac.uk.

The need for additional immunosuppressive agents

Do we need another T-cell suppressive agent, when calcineurin inhibitors (cyclosporin and tacrolimus) seem to work so well? The arrival of rapamycin, structurally similar to tacrolimus and binding the same intracellular protein, but with a more downstream mode of action in the T-cell activation cascade, is likely to challenge this view. The Seventeenth World Congress of the Transplant Society heard the results of early phase III trials [1,2].

At present, cyclosporin and tacrolimus are the drugs of choice in clinical transplantation. However, both are toxic to kidneys and other organs. . . . [Full Text of this Article]

Discovery and mode of action of rapamycin

The ongoing trials

Rapamycin in addition to cyclosporin
Rapamycin instead of cyclosporine
Rapamycin and chronic graft nephropathy

Side-effects of rapamycin

Conclusion

References


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