Artigo Acesso aberto Revisado por pares

Calcineurin Inhibitors: 40 Years Later, Can’t Live Without …

2013; American Association of Immunologists; Volume: 191; Issue: 12 Linguagem: Inglês

10.4049/jimmunol.1390055

ISSN

1550-6606

Autores

Jamil Azzi, Mohamed H. Sayegh, Samir Mallat,

Tópico(s)

Biochemical and Molecular Research

Resumo

Abstract Calcineurin inhibitors (CNIs) revolutionized the field of organ transplantation and remain the standard of care 40 years after the discovery of cyclosporine. The early impressive results of cyclosporine in kidney transplant recipients led to its subsequent use in other organ transplant recipients and for treatment of a variety of autoimmune diseases as well. In this review, we examine the discovery of CNIs, their mechanism of action, preclinical and clinical studies with CNIs, and the usage of CNIs in nontransplant recipients. We review the mechanisms of renal toxicity associated with CNIs and the recent efforts to avoid or reduce usage of these drugs. Although minimization strategies are possible, safe, and of potential long-term benefit, complete avoidance of CNIs has proven to be more challenging than initially thought.

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