Anti-interleukin-2 receptor antibodies—basiliximab and daclizumab—for the prevention of acute rejection in renal transplantation

Abstract

The use of antibody induction after kidney transplantation has increased from 25% to 63% in the past decade and roughly one half of the induction agent used is antiinterleukin-2 receptor antibody (IL-2RA, ie, basiliximab or daclizumab). When combined with calcineurin inhibitor (CNI)-based immunosuppression, IL-2RAs have been shown to reduce the incidence of acute rejection, one of the predictors of poor graft survival, without increasing risks of infections and malignancies in kidney transplantation. For low-immunological-risk patients, IL-2RAs, as compared with lymphocyte-depleting antibodies, are equally efficacious and have better safety profiles. For high-risk patients, however, IL-2RAs may be inferior to lymphocyte-depleting antibodies for the prophylaxis of acute rejection. In an effort to reduce toxicities of other immunosuppressive medications without increasing the risk of acute rejection and chronic graft loss, IL-2RAs have often been combined with steroid-and CNI-sparing immunosuppression protocols. More data support the benefits of early steroid withdrawal with IL-2RA in low-risk patients, but preferred induction therapy for high-risk patients has yet to be determined. Although CNI-sparing protocols with IL-2RA may preserve renal function and improve long-term survival in selected patients, further studies are needed to identify those who benefit most from this strategy.

Evidence to support a drain-free strategy in kidney transplantation using a retrospective comparison of 500 consecutively transplanted cases at a single center

“…All patients received dual induction immunosuppression with rabbit antithymocyte globulin/basiliximab and maintenance consisting of tacrolimus/mycophenolic acid and corticosteroid avoidance [28][29][30]. Pre-operative single prophylactic dose of a 1st generation cephalosporin (or quinolone in case of a reported allergy to the former) was given in the attempt to prevent the development of a post-operative wound infection.…”

Functions and Uses of Immunohistochemical Stains in Cutaneous Infiltrates of Hematopoietic Origin: A Review for the Practicing Dermatologist

“…[55][56][57] Anti-CD25 medications are also routinely used for treating graft-versus-host disease and preventing transplant rejection and are being investigated in a variety of inflammatory conditions, including psoriasis and inflammatory bowel disease. [58][59][60][61] CD30 CD30 is a receptor belonging to the tumor necrosis factor family of proteins. 62 It is expressed by activated B and T cells and activated macrophages.…”

Non‐IL‐2‐blocking anti‐CD25 antibody inhibits tumor growth by depleting Tregs and has synergistic effects with anti‐CTLA‐4 therapy

“…Since these two antibodies can block IL-2 binding to CD25 on Teffs, they will destroy the function of Teffs, which is not beneficial to antitumor immunity. [30][31][32] The binding sites of these two antibodies to CD25 overlap with the binding site of IL-2 to CD25, 33,34 which blocks the IL-2 signaling pathway to suppress Teff activation. 35,36 CD25 is expressed at a significantly higher level on Tregs than Teffs.…”

“…The previously marketed anti‐CD25 antibodies, Basiliximab 24–26 and Daclizumab 27–29 have been primarily used to prevent and inhibit graft rejection. Since these two antibodies can block IL‐2 binding to CD25 on Teffs, they will destroy the function of Teffs, which is not beneficial to antitumor immunity 30–32 . The binding sites of these two antibodies to CD25 overlap with the binding site of IL‐2 to CD25, 33,34 which blocks the IL‐2 signaling pathway to suppress Teff activation 35,36 .…”