Nephrol Dial Transplant (2004) 19: 1677-1681
Nephrol Dial Transplant Vol. 19 No. 7 © ERA-EDTA 2004; all rights reserved
Editorial Comment
FTY720—the first compound of a new promising class of immunosuppressive drugs
1 Division of Nephrology and Hypertension and 2 Institute of Immunology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
Correspondence and offprint requests to: Professor Dr Ulrich Kunzendorf, University Hospital of Schleswig-Holstein, Campus Kiel, Division of Nephrology and Hypertension, Schittenhelmstr. 12, D-24105 Kiel, Germany. Email: kunzendorf@nephro.uni-kiel.de
Keywords: FTY720; kidney transplantation; immunosuppression
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Introduction |
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Immunosuppressive regimens containing cyclosporin or tacrolimus have reduced acute kidney graft rejections to an incidence as low as 10–30%, but acute rejections remain one of the strongest predictors for long-term kidney graft function [1–3]. Even though an increased dosage of calcineurin inhibitors can easily suppress rejection episodes, the risk of chronic transplant nephropathy, cardiovascular diseases and diabetes mellitus rises concomitantly with such treatments [4–6]. Therefore, standard immunosuppressive regimes combine calcineurin inhibitors with azathioprin, mycophenolate mofetil or rapamycin and corticosteroids, which inhibit an ongoing immune response synergistically. FTY720 is the first compound of a new class of immunosuppressive drugs that exhibit the potency to suppress initiation and continuation of a rejection using a different mechanism in comparison with other known immunosuppressive drugs.
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Recirculation of lymphocytes is a prerequisite for an immune response |
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The immunosuppressive effect of FTY720 relies on inhibition of lymphocyte recirculation. The initiation as well as the effector phase of an
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A new target for immunosuppression: sphingosine-regulated lymphocyte traffic |
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FTY720 effectively suppresses allotransplant rejections and autoimmune disorders in various animal models |
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FTY720 in renal transplantation—human trials |
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