Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MONOCLONAL ANTIBODIES: Monoclonal antibodies have been humanized to improve their duration of action and their tolerance. Lymphocyte-depleting humanized anti-CD3 antibodies are globally well tolerated. Coupled with an immunotoxin, Campath 1H, a humanized anti-CD3 antibody with specific anti-CD52 depleting properties which also depletes immunocompetent cells, is being tested. There is increasing interest in the use of monoclonal antibodies in combination with rapamycin. SIROLIMUS AND EVEROLIMUS: The half-life of sirolimus is twice that of everolimus. Otherwise quite similar, these compounds have dose-dependent side effects: leukopenia, thrombocytopenia, hyperlipidemia. There use allows a lower dosage for the calcineurin inhibitor. Sirolimus is particularly active in reducing intimal proliferation within the vessel walls. Precise indications at the present time include induction of tolerance, withdrawal of the calcineurin inhibitor, use of low-dose calcineurin inhibitor, and corticosteroid withdrawal. ELIMINATING THE SIDE EFFECTS OF CORTICOSTEROIDS: Complications resulting from the use of corticosteroids, particularly bone complications, are still a problem with the low doses used in long-term regimens for transplant recipients. Several means have been proposed to reduce the risk. Total withdrawal is possible, but the risk of an increased rate of acute rejection limits indications. It appears that total withdrawal then complete abstention is not compatible immunologically. IMMUNOSUPPRESSORS IN PERSPECTIVE: Three groups of compounds have immunosuppressor potential: anti-adhesion molecule antibodies, co-stimulation blockers, and molecules inhibiting T-lymphocyte activators and their signalization factors.
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PMID:[Immunosuppression, ongoing clinical trials]. 1157 87

The introduction of new immunosuppressive agents and protocols has improved outcomes for renal transplant recipients by decreasing the risk of rejection and by increasing the function and lifespan of the allograft. This article reviews the major changes in the combinations of therapies used: calcineurin inhibitors, target of rapamycin inhibitors, mycophenolate mofetil, non-depleting monoclonal versus depleting monoclonal and polyclonal antibodies for induction and increasing emphasis on protocols for reduction or avoidance of steroids and calcineurin inhibitors. The new agents with novel immunological targets such as anti-CD40 ligand, LEA29Y, FTY720, anti-CD20 (rituximab, Rituxan, Mabthera) and anti-CH52 (alemtuzumab, Campath), which are under development but have yet to survive the rigors of clinical trials are also discussed. In the presence of low early rejection rates, immunosuppressive therapy is setting new goals such as better graft function (glomerular filtration rates), reduction in adverse effects such as hypertension, hyperlipidaemia and drug toxicity and, above all, the prevention of late graft deterioration.
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PMID:New developments in immunosuppressive therapy in renal transplantation. 1207 85