Recent advances in immunosuppressive therapy for prevention of renal allograft rejection
- 1 August 2011
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Organ Transplantation
- Vol. 16 (4), 390-397
- https://doi.org/10.1097/mot.0b013e328348b420
Abstract
Current immunosuppressive therapies are highly successful at regulating acute allograft rejection and inducing long-term transplanted kidney survival; however, currently available medications are associated with generalized immune suppression and drug toxicities, including nephrotoxicity. In recent years, advances in immunosuppression that target specific pathways involved in immune activation have been developed. In particular, promising medications are currently under evaluation that target ischemia-reperfusion injury as well as the cellular and humoral branches of the adaptive immune response. Targets of T-cell-mediated activation include antibodies and fusion proteins interfering with LFA-1/ICAM-1, CD2/LFA-3, CD40/CD154, and CD28/B7.1 and B7.2 interactions. Intracellular targets involved in T- and B-cell activation pathways are being evaluated, including protein kinase C inhibitors, Janus-associated kinase (JAK) inhibitors, and proteasome inhibitors. Several new medications demonstrate promise in inhibiting donor-directed humoral immunity by targeting B-cell-activating factor (BAFF) and complement activation pathways. The present review evaluates the recent clinical advances in immunosuppressive therapies for kidney transplantation. Publications regarding advances in immunosuppressive therapies over the past year were evaluated in the context of the specific immune pathways involved in allograft rejection.Keywords
This publication has 55 references indexed in Scilit:
- rPSGL-Ig for Improvement of Early Liver Allograft Function: A Double-Blind, Placebo-Controlled, Single-Center Phase II Study†American Journal of Transplantation, 2011
- Diannexin Decreases Inflammatory Cell Infiltration Into the Islet Graft, Reduces β-Cell Apoptosis, and Improves Early Graft FunctionTransplantation, 2010
- Evidence for Antibody-Mediated Injury as a Major Determinant of Late Kidney Allograft FailureTransplantation, 2010
- Histopathologic Clusters Differentiate Subgroups Within the Nonspecific Diagnoses of CAN or CR: Preliminary Data from the DeKAF StudyAmerican Journal of Transplantation, 2010
- Diannexin, a Novel Annexin V Homodimer, Protects Rat Liver Transplants Against Cold Ischemia‐Reperfusion InjuryAmerican Journal of Transplantation, 2007
- A Phase I/II Randomized Open-Label Multicenter Trial of Efalizumab, a Humanized Anti-CD11a, Anti-LFA-1 in Renal TransplantationAmerican Journal of Transplantation, 2007
- LFA-1 (CD11a) as a Therapeutic TargetAmerican Journal of Transplantation, 2006
- Neutrophil Recruitment in the Reperfused-Injured Rat Liver was Effectively Attenuated by Repertaxin, a Novel Allosteric Noncompetitive Inhibitor of Cxcl8 Receptors: A Therapeutic Approach for the Treatment of Post-Ischemic Hepatic SyndromesInternational Journal of Immunopathology and Pharmacology, 2005
- Inhibition of the chemokine receptor CXCR2 prevents kidney graft function deterioration due to ischemia/reperfusionKidney International, 2005
- P‐Selectin Glycoprotein Ligand‐1 (rPSGL‐Ig)‐Mediated Blockade of CD62 Selectin Molecules Protects Rat Steatotic Liver Grafts from Ischemia/Reperfusion InjuryAmerican Journal of Transplantation, 2002