New immunosuppressive agents in pediatric transplantation

Nguyen, Christina; Shapiro, Ron

doi:10.6061/clinics/2014(sup01)03

Cited by 20 publications

(14 citation statements)

References 70 publications

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“…Similarly, co-administration of diltiazem, verapamil, fluconazole, ketoconazole, anticonvulsants and rifampicin can altered the AUC of sirolimus [5,7,23].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

“…Beyond that, the efficacy of both drugs appears to be similar, as well as their toxicity profiles [7,[25][26][27][28].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

“…It is metabolized by both cytochrome P450 IIIA4 (CYP3A4) and Pglycoprotein, which explains the interactions with other drugs and high-fat meals and their metabolites are eradicated through gastrointestinal tract (91%) and kidneys [7,[18][19][20][21].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

“…In contrast to SRL, everolimus (EVR/RAD/Certican) is considered as a derivative of sirolimus, structurally looks similar to SLR but with additional extra hydroxyethyl chain substitution at position-40 on the sirolimus molecule, which make it more hydrophilic and bioavailable than sirolimus (figure 2) [1,4,5,[7][8][9][10][11][12][13][14][15]. Similarly EVR/FKBP-12 multiplexes acts directly to mTOR, leading to inhibition of T-cell progression from the G1 to the S stage of cell cycle, thus results in inhibition of IL-2-induced protein synthesis and cellular proliferation and inhibition of IL-4-dependent multiplications of T-and B-cells [1,4,15,16].…”

Section: Introductionmentioning

confidence: 99%

“…and acts through the co-stimulatory and cytokine-driven pathways, to prevent the signal III pathway (G1 to S transition, interpretation, and cytokine-driven T-cell multiplication) [1,[4][5][6][7][8][9][10]. The serine/threonine kinase mTOR is a downstream effector of the PI3K/AKT pathway, and forms two distinct multiprotein complexes, mTORC1 and mTORC2 (figure 1).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

m-TOR Inhibitors in the Current Practice

Alalawi¹,

Sharma²,

Halawa³

2017

J Clin Exp Nephrol

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Abstractfor long time, calcineurin-inhibitors (CNIs) was the best broadly used immunosuppressant in organ transplantation; since it had proven its efficacy in the reduction of acute rejection episodes and early graft loss, though their use in the long-term, are associated with chronic allograft nephropathy (CAN), besides it increases the cardiovascular risks such as diabetes, hypertension, and dyslipidemias. Moreover, CNIs in combination with other immunosuppressant's increases the risk of fatal infections and malignancy. Ultimately the introduction of the mammalian focus of rapamycin (mTOR) inhibitors, such as sirolimus and everolimus in 1990s, had changed the face of transplantation and conveyed a great hope to transplant physicians as an innovative class of effective immunosuppressants with a unique mechanism and less nephrotoxic effects (1-6).In this review article we will try briefly to elicit the clinical indications, advantage and disadvantage of m-TOR inhibitors over other immunosuppressant's medications and their clinical indications inside and outside the transplant field.

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“…Similarly, co-administration of diltiazem, verapamil, fluconazole, ketoconazole, anticonvulsants and rifampicin can altered the AUC of sirolimus [5,7,23].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

“…Beyond that, the efficacy of both drugs appears to be similar, as well as their toxicity profiles [7,[25][26][27][28].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%