Disseminated varicella infection in adult renal allograft recipients: role of mycophenolate mofetil

Lauzurica, Ricardo; Bayés, Beatriz; Frías, Carolina; Fontseré, Néstor; Hernández, Á; Matas, Lourdes; Jiménez, Antonio; Bonet, Josep; Romero, R.

doi:10.1016/s0041-1345(03)00684-5

Cited by 63 publications

(54 citation statements)

References 5 publications

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“…In addition, an increasing number of patients, particularly transplanted individuals, have iatrogenically induced immunodeficiency. Finally, a variety of reports stress the importance of VZV as the agent of opportunistic infection (8,14,20) The use of certain potent immunosuppressive drugs, such as mycophenolate mofetil, seems to increase the incidence of VZV infections, reinforcing the need for prompt and better control of these infections (8). Also, the treatment of chronic myelogenous leukemia may be associated with a low incidence of VZV infections (11).…”

Section: Discussionmentioning

confidence: 99%

Susceptibilities of Several Clinical Varicella-Zoster Virus (VZV) Isolates and Drug-Resistant VZV Strains to Bicyclic Furano Pyrimidine Nucleosides

Andrei

Sienaert

McGuigan

et al. 2005

Antimicrob Agents Chemother

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Varicella-zoster virus (VZV) is responsible for primary infections as well as reactivations after latency inVaricella-zoster virus (VZV) is an alphaherpesvirus that is known to be responsible for varicella in young children and for localized recurrent lesions (called zoster) later in life, due to reactivation in the ganglia. The disease can be severe in immunocompromised patients such as AIDS patients or transplant recipients. The reference drug for the treatment of immunocompromised patients presenting with VZV infections and of patients presenting with zoster is acyclovir (ACV) (7). Recently, brivudine (BVDU), another nucleoside analog, has been marketed for the treatment of varicella and zoster (15,23).We have demonstrated that several members of a new class of antivirals, the bicyclic pyrimidine nucleoside analogues (BCNAs), are highly potent and selective inhibitors of VZV in vitro (3-5, 12, 13, 16-18). This new class of compounds exhibits exclusive specificity for VZV and obligatorily requires an alkyl or alkylaryl side chain at the furan moiety for potent anti-VZV activity.ACV-resistant VZV strains have been reported to emerge with increasing frequency in immunocompromised patients after long-term therapy with ACV (1). These observations justify drug sensitivity evaluation of resistant viral strains obtained after exposure to molecules belonging to different classes of antiviral agents.The present work demonstrates the exquisite antiviral activity of a selection of the most potent BCNAs against a broad range of clinical VZV isolates. These BCNA molecules were also investigated for their activity against VZV strains that were selected in the presence of several of the BCNAs, demonstrating that the BCNAs select for drug-resistant VZV phenotypes resulting from mutations in the virus-encoded thymidine kinase (TK).

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Section: Discussionmentioning

confidence: 99%

Susceptibilities of Several Clinical Varicella-Zoster Virus (VZV) Isolates and Drug-Resistant VZV Strains to Bicyclic Furano Pyrimidine Nucleosides

Andrei

Sienaert

McGuigan

et al. 2005

Antimicrob Agents Chemother

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“…Actually, MMF therapy has been related to several infections, sometimes life-threatening, by viruses like cytomega lovirus, poliomavirus, varicella (80,81). The infection risk would be higher compared to that of patients on azathioprine (80,82).…”

Section: Severe Adverse Eventsmentioning

confidence: 99%

Mycophenolic acid in Rheumatology: mechanisms of action and severe adverse events

Zizzo¹,

Santis²,

Ferraccioli³

2011

Reumatismo

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MPA is clinically administered as morfolinoethyl ester (mycophenolate mofetil, MMF) or, more recently, as a salt (enteric-coated mycophenolate sodium). It is a fermentation product of Penicillium brevicompactum and other analogue fungi, identified by Gosio in 1893 as a weak antibacterial agent; in 1969 Franklin and Cook discovered its capacity to inhibit the inosine mono phosphate dehydrogenase (IMPDH), an enzyme involved in purine nucleotide synthesis (1)..

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“…Whereas prior reports indicated dissemination in up to 33% of renal transplant recipients (43), most recent studies (37-40) do not describe clinical dissemination. Visceral dissemination in the immunosuppressed transplant recipient ( Figure 2C), whether due to primary infection in adults or reactivation, is a life-threatening emergency (44)(45)(46). The clinical syndrome includes fever, abdominal pain, disseminated intravascular coagulation and hepatitis often accompanied by pneumonitis and pancreatitis.…”

Section: Clinical Manifestations Of Vzv Diseasementioning

confidence: 99%

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

Miller

Dummer

2007

American Journal of Transplantation

102

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Herpesvirus infections are common complications of organ transplantation. The most frequent herpesvirus infections are caused by cytomegalovirus (CMV), herpes simplex (HSV) and varicella zoster (VZV). Despite expansion of the therapeutic armamentarium, HSV and VZV continue to cause morbidity and occasional mortality in transplant recipients. Here we review the incidence and risk factors for HSV and VZV disease, their clinical presentation, effects of newer immunosuppressive regimens and prophylaxis for HSV and VZV in solid organ transplant recipients.

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Disseminated varicella infection in adult renal allograft recipients: role of mycophenolate mofetil

Cited by 63 publications

References 5 publications

Susceptibilities of Several Clinical Varicella-Zoster Virus (VZV) Isolates and Drug-Resistant VZV Strains to Bicyclic Furano Pyrimidine Nucleosides

Susceptibilities of Several Clinical Varicella-Zoster Virus (VZV) Isolates and Drug-Resistant VZV Strains to Bicyclic Furano Pyrimidine Nucleosides

Mycophenolic acid in Rheumatology: mechanisms of action and severe adverse events

Herpes Simplex and Varicella Zoster Viruses: Forgotten but Not Gone

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